Does maternal tobacco smoking modify the effect of alcohol on fetal growth?

Smoking and drinking habits were registered by a self-administered questionnaire in 36th week of gestation in 11,698 pregnant women, more than 80 percent of all such women in two Danish cities 1984-87. Alcohol consumption of 120 g/week or more was associated with a greater reduction in the average birthweight in the babies of smokers than of nonsmokers (about 40 grams for the nonsmokers and about 200 grams for the smokers). This is particularly striking considering that the average birthweight for smokers is lower than for non-smokers. A birthweight difference of more than 500 grams was found between babies of mothers who neither smoked nor drank and mothers who smoked and drank heavily. Our data suggest that women's smoking habits should be taken into consideration when giving pregnant women advice about drinking.