{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T02:44:40Z","timestamp":1774665880680,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","issue":"7051","license":[{"start":{"date-parts":[[1996,7,27]],"date-time":"1996-07-27T00:00:00Z","timestamp":838425600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1996,6,19]]},"published-print":{"date-parts":[[1996,7,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective<\/jats:bold>\n                    : To investigate the effects of exposure to tobacco smoke and of parental consumption of alcohol and illegal drugs as risk factors for the sudden infant death syndrome after a national risk reduction campaign which included advice on prenatal and postnatal avoidance of tobacco smoke.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design<\/jats:bold>\n                    : Two year population based case-control study. Parental interviews were conducted for each infant who died and four controls matched for age and date of interview.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting<\/jats:bold>\n                    : Three regions in England with a total population of 17 million people.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Subjects<\/jats:bold>\n                    : 195 babies who died and 780 matched controls.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : More index than control mothers (62.6% v 25.1%) smoked during pregnancy (multivariate odds ratio = 2.10; 95% confidence interval 1.24 to 3.54). Paternal smoking had an additional independent effect when other factors were controlled for (2.50; 1.48 to 4.22). The risk of death rose with increasing postnatal exposure to tobacco smoke, which had an additive effect among those also exposed to maternal smoking during pregnancy (2.93; 1.56 to 5.48). The population attributable risk was over 61%, which implies that the numbers of deaths from the syndrome could be reduced by almost two third if parents did not smoke. Alcohol use was higher among index than control mothers but was strongly correlated with smoking and on multivariate analysis was not found to have any additional independent effect. Illegal drug use was more common among the index parents, and paternal use of illegal drugs remained significant in the multivariate model (4.68; 1.56 to 14.05).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : This study confirms the increased risk of the sudden infant death syndrome associated with maternal smoking during pregnancy and shows evidence that household exposure to tobacco smoke has an independent additive effect. Parental drug misuse has an additional small but significant effect.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:boxed-text position=\"float\">\n                      <jats:sec>\n                        <jats:title>Key messages<\/jats:title>\n                        <jats:list list-type=\"bullet\">\n                          <jats:list-item>\n                            <jats:p>Exposure of babies to tobacco smoke from other members of the household before or after birth increases the risk of death: the greater the exposure the higher the risk<\/jats:p>\n                          <\/jats:list-item>\n                          <jats:list-item>\n                            <jats:p>Over 60% of such deaths may be attributable to the effects of exposure to tobacco smoke before and after birth<\/jats:p>\n                          <\/jats:list-item>\n                        <\/jats:list>\n                      <\/jats:sec>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1136\/bmj.313.7051.195","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:41:49Z","timestamp":1319744509000},"page":"195-198","source":"Crossref","is-referenced-by-count":242,"title":["Smoking and the sudden infant death syndrome: results from 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy"],"prefix":"10.1136","volume":"313","author":[{"given":"Peter S","family":"Blair","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J","family":"Fleming","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Bensley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iain","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Bacon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jem","family":"Berry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Golding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Tripp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1996,7,27]]},"reference":[{"key":"2025122310325519000_313.7051.195.1","unstructured":"Wigfield R Fleming PJ .The prevalence of risk factors for SIDS: the impact of an intervention campaign. In: Rognum TO , ed.Sudden infant death syndrome: new trends in the nineties. Oslo: Scandinavian University Press,1995: 124\u20138."},{"key":"2025122310325519000_313.7051.195.2","unstructured":"The National Advisory Body for CESDI .Annual report for 1994. London: Department of Health,1996."},{"key":"2025122310325519000_313.7051.195.3","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1976.02120120041005"},{"key":"2025122310325519000_313.7051.195.4","unstructured":"Hoffman HJ Hunter JC Ellish NJ Janerick DT Goldberg J .Adverse reproductive factors and the sudden infant death syndrome. In: Harper RM Hoffman HJ eds.Sudden infant death syndrome: risk factors and basic mechanisms. New York: PMA Publishing,1988: 153\u201375."},{"key":"2025122310325519000_313.7051.195.5","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1136\/bmj.300.6734.1237","article-title":"Signs of illness preceding sudden unexpected death in infants.","volume":"300","author":"Gilbert","year":"1990","journal-title":"BMJ"},{"key":"2025122310325519000_313.7051.195.6","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/0277-9536(89)90059-2","article-title":"Sudden infant death in Tasmania 1980-1986: a seven year prospective study.","volume":"29","author":"McGlashan","year":"1989","journal-title":"Soc Sci Med"},{"key":"2025122310325519000_313.7051.195.7","unstructured":"Engelberts A .Cot death in the Netherlands: an epidemiological study. Amsterdam: VU University Press,1991. (MD Thesis.)"},{"key":"2025122310325519000_313.7051.195.8","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1093\/oxfordjournals.aje.a116180","article-title":"Maternal smoking, low birth weight and ethnicity in relation to sudden infant death syndrome.","volume":"134","author":"Li","year":"1991","journal-title":"Am J Epidemiol"},{"issue":"suppl","key":"2025122310325519000_313.7051.195.9","first-page":"S3","article-title":"et al. Four modifiable and other major risk factors for cot death: the New Zealand study.","volume":"28","author":"Mitchell","year":"1992","journal-title":"J Paediatr Child Health"},{"key":"2025122310325519000_313.7051.195.10","doi-asserted-by":"crossref","unstructured":"Nicholl JP O'Cathain A .Antenatal smoking, postnatal passive smoking, and sudden infant death syndrome. In: Poswillo D Alberman E , eds.Effects of smoking on the fetus, neonate and child. Oxford: Oxford Medical Publications,1992.","DOI":"10.1093\/oso\/9780192622600.003.0011"},{"key":"2025122310325519000_313.7051.195.11","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1542\/peds.90.6.905","article-title":"Relationship of sudden infant death syndrome to maternal smoking during and after pregnancy.","volume":"90","author":"Schoendorf","year":"1992","journal-title":"Paediatrics"},{"key":"2025122310325519000_313.7051.195.12","unstructured":"Mitchell EA .Smoking: the next major and modifiable risk factor. In: Rognum TO , ed.Sudden infant death syndrome: new trends in the nineties. Oslo: Scandinavian University Press,1995: 114\u20138."},{"key":"2025122310325519000_313.7051.195.13","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1542\/peds.91.5.893","article-title":"et al. Smoking and the sudden infant death syndrome.","volume":"91","author":"Mitchell","year":"1993","journal-title":"Paediatrics"},{"key":"2025122310325519000_313.7051.195.14","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2105\/AJPH.80.1.29","article-title":"Cigarette smoking as a risk factor for sudden infant death syndrome.","volume":"80","author":"Haglund","year":"1990","journal-title":"Am J Public Health"},{"key":"2025122310325519000_313.7051.195.15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520340051035"},{"key":"2025122310325519000_313.7051.195.16","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1136\/bmj.301.6743.85","article-title":"The interaction between bedding and sleeping position in sudden infant death syndrome: a population-based case-control study.","volume":"301","author":"Fleming","year":"1990","journal-title":"BMJ"},{"key":"2025122310325519000_313.7051.195.17","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1136\/bmj.304.6822.282","article-title":"Can the fall in Avon's sudden infant death rate be explained by the observed sleeping position changes?","volume":"304","author":"Wigfield","year":"1992","journal-title":"BMJ"},{"key":"2025122310325519000_313.7051.195.18","doi-asserted-by":"publisher","DOI":"10.1136\/adc.67.3.272"},{"key":"2025122310325519000_313.7051.195.19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7051.191"},{"key":"2025122310325519000_313.7051.195.20","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1093\/oxfordjournals.aje.a114174","article-title":"Estimating the population attributable risk for multiple risk factors using case control data.","volume":"122","author":"Bruzzi","year":"1985","journal-title":"Am J Epidemiol"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.313.7051.195","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.313.7051.195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T18:33:04Z","timestamp":1766514784000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.313.7051.195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,7,27]]},"references-count":20,"journal-issue":{"issue":"7051","published-online":{"date-parts":[[1996,7,27]]},"published-print":{"date-parts":[[1996,7,27]]}},"alternative-id":["10.1136\/bmj.313.7051.195"],"URL":"https:\/\/doi.org\/10.1136\/bmj.313.7051.195","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,7,27]]}}}