Aims: Intrauterine exposure to tobacco smoke products has been associated with long-term neurobehavioral effects. Modified appetite control might explain the recently observed association between maternal smoking during pregnancy and obesity in offspring.

Methods: Some 10,557 British adults aged 42 years born between 3-9 March 1958 were followed up in a birth cohort study (NCDS). The main outcome measure was self-reported poor appetite at age 42 years and main exposure was maternal smoking during pregnancy.

Results: The proportion of offspring with poor appetite increased with maternal smoking during pregnancy: non-smoking 4.5%; (4.0%-5.0%), medium smoking 5.6%; (4.5%-6.8%), variable smoking 6.8%; (4.9%-9.1%) and heavy smoking 7.7%; (6.3%-9.4%). The unadjusted odds ratios for maternal smoking during pregnancy (ever/never) and poor appetite is 1.49 (1.25-1.77) and after adjustment for BMI at 42 years and other potential confounding factors it is 1.22 (1.01-1.48).

Conclusions: Offspring of mothers who smoked during pregnancy were more likely to report a poor appetite independent of a number of potential confounding factors. Although not in the expected direction, the results suggest maternal smoking during pregnancy may influence appetite perception through a developmental influence or through confounding by social factors.