Project 1: Tobacco Smoke Exposure, Epigenetics and Cognitive Deficits in Children


Project Co-Leaders: Scott Kollins, PhD and Bernard Fuemmeler, PhD

  • Co-Investigator: Cathrine Hoyo, PhD

  • Faculty Development Investigator: Julia Schechter, PhD 

Children have different capacities for learning. For some, it takes a lot of effort to learn skills that others pick-up quickly. When a child has difficulty paying attention, is easily distracted, or is always on the go, it can be difficult for him/her to learn how to be successful in the classroom, with their peers, or at home. Often times this can be very distressing for the child and their parents. In some instances, it can lead to a diagnosis of Attention Deficit Hyperactivity Disorder. NICHES seeks to understand what causes the differences in children with regard to their ability to learn and develop.

The NICHES study wants to know if biological factors, like epigenetics, influence children’s cognitive and behavioral development. One particular biological process we are studying is called epigenetics, which is the study of how genes may work differently as a result of environmental events. To learn more about epigenetics, click here. Epigenetics is an exciting, new area of research in the field of child health and developmental. Duke University is one of the few places in the country that is doing this type of work. Prior research shows that environmental toxins, like second-hand smoke and blood lead levels, influence children’s brain development in-utero and their later cognitive and behavioral capacities. What has yet to be discovered is whether or not epigenetics plays a role in these processes.
The NICHES team believes that there may be epigenetics processes that are both affected by toxins and play a role in children’s brain development. NICHES hopes to identify these biological signals at birth or early in infancy. This would provide an enormous window of opportunity for preventing some of the learning and behavioral problems that children exposed to toxins might be at risk for developing. It may also be possible to develop therapies that can be administered to reduce the effects of early toxin exposure; thereby reducing the risk for cognitive and behavioral impairments in children. Right now there is no way to prevent ADHD or other cognitive and developmental problems. NICHES will help determine whether epigenetic processes can be important in prevention of child cognitive and behavioral developmental problems.
The potential benefits to children with ADHD or other learning difficulties are enormous. However, to do this research, we need you and your child’s help. We are seeking the help of families regardless of whether or not their child has been exposed to toxins or experienced learning difficulties. We hope that you will help us move this research forward!                   
Frequently Asked Questions
Why are we interested in child brain development and behavior? Early brain development and behavior sets the stage for children as they enter school and develop as adolescence and young adults. Optimizing healthy brain development in early childhood produces the best return on investment. By improving brain health and cognitive development in early childhood, it may be possible to prevent many of the problems that we see in society today, such as mental health problems, addiction and chronic disease.  
Are you only interested in attention deficit hyperactivity symptoms? ADHD signifies that a child is struggling with attention and impulse control. Attention and impulse control are critically important to learning and regulating emotion. We can learn more about cognitive, emotional, and behavioral development by focusing on ADHD-like patterns. 
Don’t we already know smoking is bad for children’s health?  Tobacco smoke contains a host of toxins that are bad for health and brain development. What we don’t know is the degree to which secondhand smoke (SHS) affects epigenetic marks that are relevant to child cognitive and behavioral development. In this study, we are looking at SHS ; however, as we move forward we also hope to examine other toxins that may be relevant, like lead, Bisphenol A (the chemical found in some plastics), pollution and even stress. 
I never smoked cigarettes or I quit – am I still eligible? In order to conduct our research, we need the help of all families regardless of whether you or anyone in your family has ever smoked. 
I’m a Newborn Epigenetic Study (NEST) participant, why are you contacting me about NICHES? As a NEST participant, you and your child have been followed from your pregnancy to your child’s birth and now to his/her early development. As your child ages, we are able to better measure his/her cognitive development. Your family has already contributed a lot to research on epigenetics and we are thankful for your time and efforts. We hope you will remain with us so that we can continue to learn more about epigenetics and child cognitive development.         
What’s involved in participation? The study will take place over a 5-year period. We will ask you to come to the ADHD clinic at Duke on two occasions during that time. When you arrive at the clinic, you and your child will meet with our staff  for an overview of  the study and consent. Your child will then complete a series of task, some with our research staff and some on the computer. These tasks will assess your child’s cognitive and learning skills. We will ask you to complete several of these same tasks as well as a survey. When you are done with the tasks, we will take a saliva sample and/or a blood sample. These biological samples will be analyzed to determine epigenetic signals as well as cotinine (a metabolite of cigarette smoke) and lead levels.  
What do we get for participating?  You and your child will be helping future families with children who have ADHD or another learning or behavioral problem. However, we also understand that participation takes time. We will financially compensate you for your time and travel. In addition, we will provide you with the results of the cognitive tests we perform at the clinic. If you agree to the blood sample, we will also provide you with the results of the blood cotinine and lead level testing. If there are any concerns regard your child’s cognitive testing and/or his/her lead levels, we will provide you with help in identifying resources that can assist you with more definitive testing.      


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