Maternal smoking, birth weight, infant death, and the self-selection problem.

Several aspects of the relationship between maternal smoking and birth weights of infants are discussed. No satisfactory explanation for Yerushalmy's results has been given other than that low birth weight appears to relate more to the smoker than to the smoking. Recent studies by Silverman support this position. The possibility that nicotine may induce a physiologic response that serves to alleviate bioenergetic deficiency in some individuals should not be overlooked. In this view, both smoking and low birth weight are symptoms of deficient maternal bioenergetic systems.