Update and extension of the Brazil SimSmoke model to estimate the health impact of cigarette smoking by pregnant women in Brazil

Szklo, André Salem; Yuan, Zhe; Levy, David T.

doi:10.1590/0102-311x00207416

Cited by 11 publications

(6 citation statements)

References 28 publications

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“…Additionally, the findings of reduced smoking during pregnancy are in line with existing evidence 2. Reported smoking prevalence by pregnant women (5.9%) was lower than national estimates of adult smoking in Brazil (10.1%–15%)32 but quite comparable to other national survey estimates for smoking among pregnant women in 2008 (7.7%)33 and 2013 (4.7%) 34. There may be differences due to wealthier urban populations surveyed and potential for under-reporting bias through telephone interviewing, but the comparability of maternal smoking estimates suggest the findings are nationally representative 26…”

Section: Discussionsupporting

confidence: 85%

“…Furthermore, model specifications account for trends over time— including gradual improvements in data quality—and there would have to be changes in data recording quality concurrent with the variable introduction of SFL to bias these results. Data limitations restricted other potentially relevant analyses (notably of preterm births as gestational age was recorded in categories until 201134) and further stratification by socioeconomic groups. Fourth, the averted deaths calculation used predicted mortality rates and rounded at the municipal level.…”

Section: Discussionmentioning

confidence: 99%

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Smoke-free legislation and neonatal and infant mortality in Brazil: longitudinal quasi-experimental study

et al. 2019

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ObjectiveTo examine the associations of partial and comprehensive smoke-free legislation with neonatal and infant mortality in Brazil using a quasi-experimental study design.DesignMonthly longitudinal (panel) ecological study from January 2000 to December 2016.SettingAll Brazilian municipalities (n=5565).ParticipantsInfant populations.InterventionSmoke-free legislation in effect in each municipality and month. Legislation was encoded as basic (allowing smoking areas), partial (segregated smoking rooms) or comprehensive (no smoking in public buildings). Associations were quantified by immediate step and longer term slope/trend changes in outcomes.Statistical analysesMunicipal-level linear fixed-effects regression models.Main outcomes measuresInfant and neonatal mortality.ResultsImplementation of partial smoke-free legislation was associated with a −3.3 % (95% CI −6.2% to −0.4%) step reduction in the municipal infant mortality rate, but no step change in neonatal mortality. Comprehensive smoke-free legislation implementation was associated with −5.2 % (95% CI −8.3% to −2.1%) and −3.4 % (95% CI −6.7% to −0.1%) step reductions in infant and neonatal mortality, respectively, and a −0.36 (95% CI −0.66 to−0.06) annual decline in the infant mortality rate. We estimated that had all smoke-free legislation introduced since 2004 been comprehensive, an additional 10 091 infant deaths (95% CI 1196 to 21 761) could have been averted.ConclusionsStrengthening smoke-free legislation in Brazil is associated with improvements in infant health outcomes—particularly under comprehensive legislation. Governments should accelerate implementation of comprehensive smoke-free legislation to protect infant health and achieve the United Nation’s Sustainable Development Goal three.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Smoke-free legislation and neonatal and infant mortality in Brazil: longitudinal quasi-experimental study

et al. 2019

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“…However, despite the considerable decline in prevalence overall and among women (25.3% in 1989 to 11.2 in 2013) [16–18], the number of maternal-fetal deaths in this period was devastating. A study based on available data from population surveys estimated that between 1989 and 2015, smoking during pregnancy caused 410,065 deaths due to low birth weight, 358,821 due to prematurity, and 25,070 due to placenta previa or placental abruption [19]. The authors found that tobacco control policies saved 345,403 lives ascribed to such causes, however all of these deaths could have been avoided through smoking cessation before and during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of pre-gestational and gestational smoking and factors associated with smoking cessation during pregnancy, Brazil, 2011-2012

2019

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Gestational smoking is associated with various adverse maternal and fetal outcomes. Over the last three decades, despite considerable advances in tobacco control policy in Brazil, gestational smoking has caused a considerable number of fetal deaths and disabilities. The aim of this study is to estimate the prevalence of pre-gestational and gestational smoking and to identify the factors associated with smoking cessation up to the 20 th gestational week. Methods: “Birth in Brazil” was a nationwide hospital-based study conducted from February 2011 to October 2012. Smoking prevalence and smoking cessation during pregnancy was estimated through face-to-face interviews with postpartum women during hospitalization for birth care. We performed multivariate logistic regression to verify the factors associated with smoking cessation up to the 5th month of pregnancy. Results: prevalence of pre-gestational smoking of 16.1% (CI 95% 15.3%-16.9%); prevalence of smoking any time during pregnancy of 9.6% (CI 95% 9.0%-10.3%); and prevalence of smoking cessation up to the 5th month of pregnancy of 56.7% (CI 95% 54.0%-59.4%). The factors associated with smoking cessation were residence in the North, Northeast, and Central-West of Brazil, having received at least one prenatal consultation (OR 3.51 CI 95% 1.85–6.67), more years of schooling (15 or more vs less than 7 years of schooling OR 5.54 CI 95% 2.97–10.34), living with a partner (OR 1.35 CI 95% 1.01–1.79), no children prior to the index pregnancy (OR 2.77 CI 95% 2.13–3.61), and absence of alcohol use (1.74 CI 95% 1.39–2.18) or of suspected alcohol abuse (OR 1.62 CI 95% 1.07–2.45). Conclusion: The estimated smoking rate during pregnancy in Brazil is still high and is associated with factors of increased maternal social vulnerability, which may contribute to the increased occurrence of unfavorable perinatal outcomes.

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“…In recent years, the strategy of raising cigarette taxes has reduced the prevalence of smoking and the consumption of licit cigarettes in Brazil. 1 However, a certain fraction of smokers may have migrated to cheaper, illicit cigarettes in order to save money. 2 In many low- and middle-income countries, the tobacco industry is the only source of information on the illicit cigarette market, and this information can be used in order to weaken or delay the implementation of effective tobacco control policies.…”

Section: To the Editormentioning

confidence: 99%

What is the link between household garbage and tobacco control? The case of Brazil

Szklo¹,

Silva²,

Quintaes³

et al. 2020

J Bras Pneumol.

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Update and extension of the Brazil SimSmoke model to estimate the health impact of cigarette smoking by pregnant women in Brazil

Cited by 11 publications

References 28 publications

Smoke-free legislation and neonatal and infant mortality in Brazil: longitudinal quasi-experimental study

Smoke-free legislation and neonatal and infant mortality in Brazil: longitudinal quasi-experimental study

Prevalence of pre-gestational and gestational smoking and factors associated with smoking cessation during pregnancy, Brazil, 2011-2012

What is the link between household garbage and tobacco control? The case of Brazil

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