Up to 25% of women in the U.S., Denmark and Sweden report smoking during pregnancy, despite associations of prenatal tobacco exposure with negative behavioral and cognitive outcomes. Hanan El Marroun and colleagues assessed brain morphology along with behavioral and emotional functioning of children whose mothers reported smoking in a range from one cigarette a day to more than 9 cigarettes per day during pregnancy. The results suggest that children whose mothers continued smoking have smaller total brain volumes, with smaller cortical gray and white matter volumes in particular, and exhibit more emotional problems, such as depressive symptoms and anxiety.