Reproductive and Developmental Effects of Exposure to Emerging Tobacco Products

Despite thinking to the contrary, tobacco/nicotine use exposure while pregnant remains a very real problem in the 21^st century due primarily to the use of alternative tobacco/nicotine products such as hookah, smokeless tobacco and electronic nicotine delivery devices. As a result of a variety of factors, including the Family Smoking Prevention and Tobacco Control Act (FSPTCA), indisputable evidence of the devastating health effects from use of conventional cigarettes, tobacco use is rapidly evolving and adolescent men and women of childbearing age appear to be the greatest consumers of these alternative tobacco products (ATPs) and nicotine delivery devices. Despite the apparent surge of ATP use by adolescents worldwide, effects from new and emerging smoked and smokeless tobacco (ST) products, used with increasing frequency in the US, on reproductive health, pregnancy, or fetal development, are mostly unknown. While almost all anecdotal evidence suggests that ATP are “just as dangerous to your health as cigarettes”, there is a void of strong science upon which policy regarding the effects of alternative smoked and ST products can be made to protect the reproductive/ developmental health of already vulnerable populations. Toxicological studies from my laboratory demonstrate that like traditional cigarettes, exposure to a globally-relevant smokeless tobacco product decreases sperm counts while increasing sperm DNA damage in a mouse model. Exposure of pregnant mice to the same smokeless product also reduces the incidence of pregnancy and increases the risk of fatty liver and cardiovascular risk factors in adult offspring. Our studies also show that exposure to vapor from electronic-cigarettes in utero and post-natally drastically reduce sperm counts and sperm mobility in juvenile offspring and brings about gene changes in the brain as well as altered behavior in adult male and female offspring. Preliminary findings from this laboratory also suggest that inhaled hookah smoke can also impair sperm counts following in utero exposure. While more studies are needed to better understand these effects, these translational studies suggest that early life exposure to alternative tobacco/nicotine products can adversely affect reproduction, development and long term health. Though the “face” of tobacco and use of ATP in the US is changing rapidly, the science lags woefully behind.