According to the United States Census Bureau, excluding California, Indiana, New York, and South Dakota, a total of 3,124,110 American women reported smoking cigarettes during their pregnancy in 1997. 

(Source: U. S. National Center for Health Statistics, National Vital statistics Reports [NVSR}, formerly Monthly Vital Statistics Reports, in the U. S. Census Bureau, Statistical Abstract of the United States: 2000 [120th edition] Washington, DC, 1999, p. 81.)

"Are young children more aggressive when they spend a lot of time in day care? That appeared to be the disturbing conclusion of a study of more than 1,100 children in 10 U.S. cities released last week by the National Institute of Child Health and Human Development. Researchers found that 17 percent of children who spent more than 30 hours a week in nonmaternal care had behavior problems (such as hitting, interrupting others or bullying). These findings generally held up whether families were rich or poor. Only 6 percent of children who spent less than 10 hours a week in day care had similar problems."

(Source: Barbara Kantrowitz, "New Battle Over Day Care," Newsweek, April 30, 2001, p. 38.)

In recent years, public health officials have worked zealously to protect infants from second-hand smoke by urging their parents to quit.  Belatedly, these officials are now realizing that these efforts will count for little if non-smoking parents hand their offspring off to smoking day-care providers.

In a recent study of the effects of environmental tobacco smoke (ETS) on 99 infants in the suburban Detroit, pediatric researchers from the Henry Ford Hospital and the Medical College of Georgia were "surprised to find that a noticeable proportion of children with nonsmoking parents showed evidence of relatively high levels of ETS exposure," as measured by determining the continine/creatinine ratios (CCR's) in their urine.  What was going on?  Further investigation revealed, "smoking by many adults beyond an infant's parents significantly contributes to the average quantity of cotinine found in the urine of infants."

More specifically, the medical scholars were able to trace significant effects of environmental smoke to "persons visited away from home, other persons living in the home, and child care away from home."  Indeed, statistical tests uncovered (but did not explain) a sizable "interaction ...between the child's sex and day care," with environmental tobacco smoke in day care affecting boy babies much more than it affected girl babies.  "For male children, ETS exposure in day care away from home increases LnCCR by 2.76, while for female children, similar exposure increases LnCCRs by only 0.59."

It would appear that, especially for boy babies, the list of documented risks of day care has just grown longer.

(Source:  Dennis R. Ownby, Christine C. Johnson, and Edward L. Peterson, "Passive Cigarette Smoke Exposure of Infants: Importance of Nonparental Sources," ARCHIVES OF PEDIATRIC AND ADOLESCENT MEDICINE 154[2000]: 1237-1241.)