Smoking during pregnancy: a difficult problem to face
PDF

Keywords

pregnancy
tobacco consumption
environmental tobacco smoke

Abstract

Introduction: Smoking tobacco during pregnancy is a preventable risk factor of adverse pregnancy outcomes. The aim of the study was to assess the impact of the information and training programme performed by the perinatal network of Auvergne, France, on smoking during pregnancy.

Methods: A multicentre before-and-after population-based study, based on two cross-sectional surveys, was carried out between July 2003 and June 2004, and December 2008 and January 2010. Pregnant women aged over 18 years old, fluently writing and speaking French were eligible. The main outcome was the prevalence of pregnant women daily smoking. The preventive programme consisted of information of women and healthcare providers and training for healthcare providers. Multivariate analysis was performed by using manual logistic regression and calculated crude and adjusted Odds Ratio.

Findings: Before and after surveys involved 1027 and 720 women, respectively. A higher percentage of women smoked daily in the after survey at diagnosis 43.49% vs. 51.94%, adjusted Odds Ratio 1.45 [1.10; 1.90] and during the third term 40.53% vs. 51.94%, adjusted Odds Ratio 1.62 [1.24; 2.12]. Environmental tobacco smoke exposure among the non-smokers was higher in the after survey 52.83% vs. 69.57% adjusted Odds Ratio 1.95 [1.54; 2.47].

Conclusion: The programme was not associated with the decrease of tobacco consumption during pregnancy. There was an increased exposure to environmental tobacco smoke. French public health authorities should introduce a new policy aimed specifically at tackling tobacco use during pregnancy and exposure to second hand smoke that takes into account the entire environment of pregnant women.

https://doi.org/10.15167/2421-4248/jpmh2016.57.2.517
PDF

References

Murin S, Rafii R, Bilello K. Smoking and smoking cessation in pregnancy. Clin Chest Med. 2011; 32: 75-91.

Maritz GS, Mutemwa M. Tobacco smoking: patterns, health consequences for adults, and the long-term health of the offspring. Glob J Health Sci. 2012; 4: 62-75.

World Health Organization. Recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy. 2013:104 pages.

Rydell M, Cnattingius S, Granath F, et al. Prenatal exposure to tobacco and future nicotine dependence: population-based cohort study. Br J Psychiatry. 2012; 200, 202-209.

DiFranza JR, Aligne CA, Weitzman M. Prenatal and postnatal environmental tobacco smoke exposure and children's health. Pediatrics. 2004; 113: S1007-1015.

Kharrazi M, De Lorenze GN, Kaufman FL, et al. Environmental tobacco smoke and pregnancy outcome. Epidemiology. 2004; 15: 660-70.

McBride CM, Emmons KM, Lipkus IM. Understanding the potential of teachable moments: the case of smoking cessation. Health Educ Res. 2003; 18:156-70.

Beck F, Guignard R, Richard JB, et al. Augmentation récente du tabagisme en France : principaux résultats du Baromètre santé, France 2010. BEH. 2011 ; 20-21 : 229-46

Malet L, de Chazeron I, Schwan R et al. L’AUDIT en question. L’Encéphale. 2005; 31: 517-522.

De Chazeron I, Llorca PM, Ughetto S, et al. Occult maternal exposure to environmental tobacco smoke exposure. Tob Control. 2007 ; 16 : 64-5.

De Chazeron I, Daval S, Ughetto S, et al. GC-MS determined cotinine in an epidemiological study on smoking status delivery. Pulm Pharmacol Ther. 2008; 21: 485-8.

Lumley J, Chamberlain C, Dowswell T, et al. Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev. 2009; 8: CD001055.

Dunkley J. Training midwives to help pregnant women stop smoking. Nurs Times. 1997; 93, 64-6.

Moss DR, Cluss PA, Watt-Morse M, et al. Targeting pregnant and parental smokers: Long-term outcomes of a practice-based intervention. Nicotine Tob Res. 2009; 11, 278–85.

Bland E, Oppenheimer L, Brisson-Carroll G, et al. Influence of an educational program on medical students' attitudes to substance use disorders in pregnancy. Am J Drug Alcohol Abuse. 2001 ; 27, 483-90.

Ramirez-Cacho WA, Strickland L, Beraun C, et al. Medical students' attitudes toward pregnant women with substance use disorders. Am J Obstet Gynecol. 2007; 196: 86.e1-5.

Aurrekoetxea JJ, Murcia M, Rebagliato M, et al. Factors associated with second-hand smoke exposure in non-smoking pregnant women in Spain: self-reported exposure and urinary cotinine levels. Sci Total Environ. 2014 ; 1, 1189-96.

World Health Organization. Environmental health inequalities in Europe. Assessment report, WHO. 2012; 212 pages.

Stead LF, Buitrago D, Preciado N, et al. Physician advice for smoking cessation. Cochrane Database Syst Rev. 2013; 5:CD000165.

Carson KV, Verbiest ME, Crone MR, et al. Training health professionals in smoking cessation. Cochrane Database Syst Rev. 2012 ; 16, CD000214.

Rattan D, Mamun A, Najman JM, et al. Smoking behaviour in pregnancy and its impact on smoking cessation at various intervals during follow-up over 21 years: a prospective cohort study. BJOG. 2013; 120, 288-295

Tong VT, Dietz PM, England LJ. Smoking cessation for pregnancy and beyond: a virtual clinic, an innovative web-based training for healthcare professionals. J Womens Health. 2012; 21, 1014-1017.

Flemming K, Graham H, Heirs, et al. Smoking in pregnancy: systematic review of qualitative research of women who commence pregnancy as smokers. J Adv Nurs. 2013; 69,1023-1036.

Hemsing N, Greaves L, O'Leary R, et al. Partner support for smoking cessation during pregnancy: a systematic review. Nicotine Tob Res. 2012; 14, 767-776.

Xu H, Wen LM, Rissel C, Baur LA. Smoking status and factors associated with smoking of first-time mothers during pregnancy and postpartum: findings from the healthy beginnings trial. Matern Child Health J. 2013; 17, 1151-1157.

Cluss PA, Levine MD, Landsittel D. The Pittsburgh STOP program: disseminating an evidence-informed intervention for low-income pregnant smokers. Am J Health Promot. 2011; 25, S75-81.

Marteau TM, Thorne J, Aveyard P, et al. Financial incentives for smoking cessation in pregnancy: protocol for a single arm intervention study. BMC Pregnancy Childbirth. 2013; 13, 66.

Ussher M, Aveyard P, Manyonda I, et al. Physical activity as an aid to smoking cessation during pregnancy (LEAP) trial: study protocol for a randomized controlled trial. Trials. 2012 ; 4,13:186.

Windsor R, Clark J, Cleary S, et al. Effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Dissemination Project: A Science to Prenatal Care Practice Partnership. Matern Child Health J. 2014; 18,180-190.

Jiménez-Muro A, Samper MP, Marqueta A, et al. Prevalence of smoking and second-hand smoke exposure: differences between Spanish and immigrant pregnant women. Gac Sanit. 2012 ; 26, 138-44.