“…Maternal tobacco smoking or exposure to environmental tobacco smoke are major risk factors for SIDS (Mitchell and Milerad, 2006) and infants born to mothers that smoke exhibit increased nicotinic acetylcholine receptor expression in brainstem nuclei that control normal respiration, arousal (Cohen et al, 2005;Duncan et al, 2008;Machaalani et al, 2011) and integrate information from cardiovascular, pulmonary, respiratory tract and gastrointestinal receptor afferents (Machaalani et al, 2011;Machaalani and Waters, 2008;Waters et al, 1999). Despite neuro-pathologic evidence of morphological and receptor binding abnormalities affecting multiple brainstem nuclei (Jaiswal et al, 2013;Machaalani et al, 2011;Slotkin et al, 1987;Smith et al, 2010), there is no consistent phenotype associated with gestational or developmental exposure to cigarette smoke or to nicotine. And, although SIDS victims show a higher incidence of respiratory abnormalities including apneas, delayed arousal responses and diminished ventilatory chemo-reflexes, the frequency of those events is low and of limited diagnostic and therapeutic utility.…”