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Chapter 10: Smoking and Low Birth Weight

Everyone knows pregnant women should not smoke.  Why?  Because smoking causes babies to be underweight.  But, does it really?  After all, it is already well known that most smokers come from the lower social classes and that same group of people tend to be unhealthy anyway largely resulting from eating food of poor nutritional value.  

I suspect that this is where the answer lies: it is no secret that the food the mother eats is what helps her baby to develop, and thus food is very important.  If a mother eats nutritionally poor food, her baby will not develop as well as it should have or could have.  Thus, here emerges the statistical link between smoking and low birth weight: a woman from a low social class smokes cigarettes and eats unhealthy food.  As a result of her unhealthy eating, she gives birth to an underweight baby.  However, she gets labelled as a smoker, and thus when smokers are studied statistically it appears that smokers have underweight babies which means, of course, that smoking causes low birth weight in newborns! With one problem it does not mean that at all.  

Correlation does not mean causation, and in that example smoking is no more a useless factor than, say, reading a magazine (statistically, of course, most pregnant women will read a magazine.  That in no way means reading that magazine results in underweight children though) what really caused her baby to be underweight was malnutrition.  In other words, the notion that smoking will lead to an underweight baby is nothing more than another ailment to afflict the lower social classes, and nothing more than proof that that group of people are unhealthier than people from the higher classes.  An important point I have referred to more than once is that after World War Two, over 85% of Americans smoked.  What this means is if smoking really did lead to low birth weight, a whole generation (or at least, a very significant part of it) would have been underweight at birth.  Accordingly, this would have led to increased numbers of infant mortality, and higher incidence of illness and disease later in life.  Then, in turn, the next generation would have been healthier and bigger.  This did not happen, and people in the 1950s and 1960s lived longer than people in the 1930s and 1940s.  Once again, looking at the bigger picture serves as an arrow through the heart of the anti-smoking crusade.  Of course, a simple theory will not suffice to win the war, so a look at the evidence is necessary.

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