Brain tumors are the second most common cancer in children after leukemia, yet the etiology of childhood brain tumors remains unknown. Tobacco smoke contains several dozen compounds that are known to be carcinogens. Among these are N-nitroso compound precursors, principally tobacco-specific nitrosamines. Although smoking has not been identified as a significant risk factor for the development of brain tumors in adults, fetuses and infants have incompletely formed blood-brain barriers that may allow the passage of carcinogenic tobacco metabolites into the central nervous system and initiate the formation of neural tumors. In this review, we present data from case-control and cohort studies published between 1971 and 1995 that examined the relationship between parental smoking during pregnancy and childhood brain tumors (CBTs). The majority of these studies found little association between CBTs and maternal smoking before or during pregnancy or between CBTs and maternal exposure to passive smoke during pregnancy.

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