Prenatal tobacco and tobacco-cannabis co-exposure: Relationship with attention and memory in middle childhood.

We examined associations between prenatal tobacco exposure (with and without cannabis exposure) and children's performance on laboratory measures of sustained attention, attentional set shifting, and working memory in middle childhood (9-12 years of child age). Participants were recruited in the first trimester of pregnancy and oversampled for prenatal tobacco exposure; with a smaller sample (n = 133; n = 34 non-substance exposed, n = 37 exposed to tobacco only, n = 62 co-exposed) invited (oversampled for co-exposure) to participate in the middle-childhood assessment (M age = 10.6, SD = 0.77; 68% Black, 20% Hispanic). Results for sustained attention indicated lower attention (percent hits) at the first epoch for tobacco only exposed compared to non-exposed and co-exposed; a trend (p = .07) towards increases in impulsive responding across time (a total of 8 epochs) for tobacco exposed (with and without cannabis) compared to non-exposed children; and a significant association between higher number of cigarettes in the first trimester and greater increases in impulsive responding across epochs. However, children prenatally exposed to tobacco (with and without cannabis) demonstrated greater short-term memory compared to children not prenatally exposed, and this difference was driven by higher scores for children prenatally co-exposed to tobacco and cannabis compared to those who were non-exposed. Overall, results suggest that prenatal tobacco exposure, especially in the first trimester, may increase risk for impulsive responding on tasks requiring sustained attention, and that co-use of cannabis did not exacerbate these associations. The higher short-term memory scores among children who were co-exposed compared to non-exposed are perplexing and need replication, particularly in studies with larger sample sizes and samples exposed only to cannabis to examine this more closely.

Early Childhood Risk and Protective Factors Predicting Resilience against Adolescent Substance Use.

We examined associations between early childhood (first 3 years of life) risk and protective factors and resilience against adolescent substance use in a prospective sample of alcoholic and non-alcoholic families. We defined resilience as low or no substance use in the context of adversity (having a father with alcohol problems). The sample included 227 families recruited from birth records when children were 12 months old and followed longitudinally to 15-17 years of child ages (n = 182). Adolescents were grouped into 4 categories: Non-challenged (non-alcoholic parent, no adolescent substance use, n = 50), Troubled (non-alcoholic parent, adolescent substance use, n = 30), Resilient (alcoholic parent, no adolescent substance use, n = 36), and Vulnerable (alcoholic parent and adolescent substance use, n = 66). Multivariate analyses were used to examine group differences (resilient vs. vulnerable; non-challenged vs. troubled) in child and parent characteristics and family relationships domains. Children in the troubled group compared to non-challenged had lower effortful control and emotion-regulation, and those in the resilient group were more unadaptable or reactive to novelty compared to the vulnerable group. Parents of resilient compared to vulnerable children reported significantly lower alcohol symptoms and more partner aggression. Finally, fathers of resilient compared to vulnerable children were less aggravated with them in early childhood. Results highlight the importance of continuous measures of alcohol problems, early childhood functioning, and family characteristics for associations with adolescent risk and resilience.Passive gene-environment correlations may account for associations between parent alcohol problem severity and adolescent substance use.