In addition to the evidence for substantial genetic effects on ADHD, there is increasing evidence for the roles of parental alcoholism and maternal drinking and smoking during pregnancy in the risk of offspring ADHD. Previous studies have associated prenatal exposure to both alcohol and nicotine with increased risk of ADHD in children. Preliminary analyses also suggested (i) significant associations between parental alcoholism and ADHD, as well as between maternal smoking during pregnancy and parental alcoholism, and (ii) evidence for a genetic correlation between parental alcoholism and offspring ADHD. Given these results, in addition to genetic transmission, increased rates of maternal smoking during pregnancy associated with parental alcoholism may be an important factor contributing to the association between parental alcoholism and ADHD. Taken together, evidence suggests that both genetic and environmental risk factors for ADHD are at work in the children of alcoholics, raising the possibility that these risk factors may interact with on e another. Using an innovative within-mother comparison approach, this pilot study will assess relative effects of maternal smoking during pregnancy on ADHD in 200 'high genetic risk' children (100 sibling pairs with alcoholic fathers) and 200 'low genetic risk' children (100 sibling pairs with no history of paternal alcoholism). The novel within-mother approach focuses on mothers who have smoked during one pregnancy but not during all pregnancies, allowing the comparison of outcomes between sibling pairs, one of which has been exposed to nicotine prenatally and the other who has not, while controlling for pertinent environmental variables (e.g., SES, parental education, etc.). Thus, the samples are chosen for environmental risk for ADHD from the maternal side (maternal smoking during pregnancy) and genetic risk for ADHD from the paternal side (those with history of DWI/alcohol problems). The sample will focus on mothers who gave birth to children between 1992-1996 (children aged 7-11). A total of 4,835 mothers who are discordant for smoking during their pregnancies have been identified from Missouri birth records. Of these, 608 have a partner (listed as the father on the child's birth record) who has been given a DWI. A total of 400 mothers will be screened for eligibility (i.e., accuracy of birth records). Those eligible to participate (200 projected) will be interviewed via telephone regarding children's ADHD, detailed smoking during pregnancy, history of smoking and nicotine dependence, history of alcohol problems and alcohol dependence, and limited parental psychopathology (i.e., screen for ADHD, screen for CD).
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