Secondhand smoke exposure during pregnancy: a cross-sectional analysis of data from Demographic and Health Survey from 30 low-income and middle-income countries

Reece, Sian; Morgan, Camille; Parascandola, Mark; Siddiqi, Kamran

doi:10.1136/tobaccocontrol-2018-054288

Cited by 52 publications

(57 citation statements)

References 26 publications

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“…Exposure to passive smoking in this study was similar for those who lived in district (urban) and those that lived in municipality (rural). A previous study indicated that urban households have lower exposure to passive smoking [13]. Likewise, a study on secondhand smoke exposure from 26 countries revealed that passive smoking is higher in urban areas relative to rural ones [14].…”

Section: Demographic Characteristics Of Passive Smokersmentioning

confidence: 94%

“…Similarly, the data also revealed that Indonesian boys are more likely to be exposed to passive smoking than girls (61.7% and 51.7% respectively) [12]. That said, passive smoking is known to be a higher risk factor to stillbirths (14% in Indonesia) than active smoking behavior [13]. Hence, protecting women and girls from passive smoking is critical, especially women of childbearing age, and can be a key strategy to improve the health of women and children.…”

Section: Demographic Characteristics Of Passive Smokersmentioning

confidence: 94%

“…Our previous study revealed that smokers are likely aware of the harms of smoking; however, because cigarettes contain the addictive substance nicotine, smoking cessation is difficult. In this case, the help and support of family members are essential for those who are trying to end smoking [13]. Spreading awareness about the side effects of passive smoking would teach people about the danger of smoking and enable them to make informed decisions about their health and the health of their families [15].…”

Section: Attitude Towards Smoking Behaviormentioning

confidence: 99%

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Passive Smokers’ Support for Stronger Tobacco Control in Indonesia

Nurhasana

Ratih

Dartanto

2020

IJERPH

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Secondhand smoke exposure in Indonesia is high, especially compared to other Southeast Asian countries. Passive smoking leads to negative impacts on health and socio-economic well-being. Therefore, increasing the price of cigarettes and, thereby, increasing barriers to access to cigarettes could be an effective way to reduce smoking prevalence and protect people from second-hand smoke. This study aims to assess passive smokers’ support for cigarette price increases in Indonesia. We perform a quantitative analysis with a cross-sectional design. The data were obtained through phone-based interviews of 1000 respondents aged 18 and older in Indonesia. Only 596 nonsmokers were included to be further analyzed in this study. This study found that 44.1% respondents have at least one family member who smokes. We considered the respondents’ age, gender, education level, employment, and the number of people living in the respondent’s household that are exposed to passive smoking. Our results demonstrate that passive smokers support stronger tobacco control such as increasing cigarette prices, regulating smoking behavior using a religious approach (Fatwa), and applying more effective pictorial health warnings.

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Section: Demographic Characteristics Of Passive Smokersmentioning

confidence: 94%

Section: Demographic Characteristics Of Passive Smokersmentioning

confidence: 94%

Section: Attitude Towards Smoking Behaviormentioning

confidence: 99%

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Passive Smokers’ Support for Stronger Tobacco Control in Indonesia

Nurhasana

Ratih

Dartanto

2020

IJERPH

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“…Studies examining the association of education and income with SHS exposure during pregnancy are limited [4][5][6][7][8][9][10][11], while there is substantial evidence that those with lower education and/or lower income are more exposed to SHS than higher ones in the general population [1,[12][13][14][15][16]. Although education and income re ect the central dimension of social strati cation, they have different meanings in society; education is thought to capture knowledge and skills, while income measures material resources to enhance health [17].…”

Section: Introductionmentioning

confidence: 99%

“…Although education and income re ect the central dimension of social strati cation, they have different meanings in society; education is thought to capture knowledge and skills, while income measures material resources to enhance health [17]. Existing studies among pregnant women have mainly focused on education [4,6,[8][9][10][11], and the association between income and SHS exposure have rarely been examined [5,7]. To the best of our knowledge, no studies have examined the association of education and income with SHS exposure during pregnancy in Japan.…”

Section: Introductionmentioning

confidence: 99%

Associations of Education and Income With Secondhand Smoke Exposure Among Non-Smoking Pregnant Women in Japan: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

Murakami¹,

Obara²,

Ishikuro³

et al. 2020

Preprint

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Background: Associations of education and income with secondhand smoke (SHS) exposure have been well documented in the general population. However, evidence among non-smoking pregnant women is limited, including in Japan. The purpose of the study was to examine the associations of education and income with SHS exposure among non-smoking pregnant women in Japan.Methods: We analyzed data from 17815 non-smoking pregnant women in Japan who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017. SHS exposure was defined as indoor exposure to someone else’s cigarette smoke ≥1 day/week during pregnancy. Multiple logistic regression analyses were conducted to examine whether pregnant women’s educational attainment or equivalent household income was associated with SHS exposure, adjusting for age, work status, smoking history, partners’ education, and income/education. Stratified analyses by work status were also conducted.Results: The prevalence of SHS exposure during pregnancy was 34.0%; 29.4% among non-working women and 37.1% among working women. Lower educational attainment was associated with an increased risk of SHS exposure; the odds ratio of high school education or lower compared with university education or higher was 1.78 (95% confidence interval, 1.59–1.99). Lower equivalent household income was associated with an increased risk of SHS exposure; the odds ratio of the lowest compared with the highest level of income was 1.67 (95% confidence interval, 1.51–1.84). These associations did not differ between non-working women and working women.Conclusions: Pregnant women with lower education and/or lower household income had higher risks of SHS exposure in Japan. These findings imply that educational interventions and financial incentives are needed for pregnant women and their household smokers in helping to reduce SHS exposure among non-smoking pregnant women.

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Brief Advice, Nicotine Replacement Therapy Sampling, and Active Referral for Expectant Fathers Who Smoke Cigarettes

et al. 2021

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IMPORTANCEPregnancy presents an opportunity to engage expectant fathers in smoking cessation, but evidence from randomized clinical trials is scarce.OBJECTIVE To evaluate the effectiveness of a proactive, combined intervention for smoking cessation in expectant fathers. DESIGN, SETTING, AND PARTICIPANTSThis pragmatic randomized clinical trial in prenatal clinics in 7 public hospitals in Hong Kong proactively recruited and enrolled 1053 participants from October 10, 2018, to February 8, 2020. Included male adults were 18 years or older, smoked cigarettes daily in the past 3 months, had partners who were pregnant and nonsmoking in the past 30 days, and had a landline or mobile telephone number for follow-up. These participants were randomized to either the intervention group or the control group. The primary analyses used an intention-to-treat approach. INTERVENTIONSThe intervention group received brief cessation advice, a 1-week free sample of nicotine replacement therapy (NRT), and active referral to a community-based smoking cessation service. The control group received only brief cessation advice with a leaflet on the hazards of perinatal exposure to tobacco smoke and the toll-free quitline telephone number. MAIN OUTCOMES AND MEASURESThe primary outcome was biochemically validated tobacco abstinence at 6 months after intervention initiation defined by an exhaled carbon monoxide level of 3 parts per million or lower. The secondary outcomes included self-reported 24-week continuous abstinence at 6 months after intervention initiation as well as 7-day point prevalence abstinence, use of any NRT, and use of a smoking cessation service at 3 and 6 months after intervention initiation.RESULTS All 1053 randomized participants were male adults with a mean (SD) age of 33.8 (6.9) years. The retention rate at 6-month follow-up was 80.7%. The primary outcome of biochemically validated tobacco abstinence at 6 months after intervention initiation was significantly higher in the intervention group than in the control group (6.8% [36 of 527 participants] vs 3.6% [19 of 526]; odds ratio [OR], 1.96; 95% CI, 1.11-3.46; P = .02). The main secondary outcomes of self-reported 24-week continuous abstinence at 6 months (OR, 1.87; 95% CI, 1.08-3.23; P = .03) and 7-day point prevalence abstinence at 3 months (OR, 1.48; 95% CI, 1.05-2.09; P = .03) and 6 months (OR, 1.74; 95% CI, 1.29-2.34; P < .001) were also significantly higher in the intervention group. The intervention group had a significantly higher increase in perceived family harmony (score range, 0-10, with a higher score indicating a higher level of harmony) from baseline to 6 months (B = 0.28; 95% CI, 0.063-0.50; P = .01).CONCLUSIONS AND RELEVANCE This trial found that combining brief advice with a 1-week sample of NRT and referral to smoking cessation programs nearly doubled the odds that expectant fathers who smoked would achieve validated abstinence compared with providing brief advice alone. The intervention was also effective in promoting family harmony.

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Secondhand smoke exposure during pregnancy: a cross-sectional analysis of data from Demographic and Health Survey from 30 low-income and middle-income countries

Abstract: We have demonstrated that SHS exposure during pregnancy is far more common than active smoking in LMICs, accounting for more stillbirths than active smoking. Protecting pregnant women from SHS exposure should be a key strategy to improve maternal and child health.

Cited by 52 publications

References 26 publications

Passive Smokers’ Support for Stronger Tobacco Control in Indonesia

Passive Smokers’ Support for Stronger Tobacco Control in Indonesia

Associations of Education and Income With Secondhand Smoke Exposure Among Non-Smoking Pregnant Women in Japan: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

Brief Advice, Nicotine Replacement Therapy Sampling, and Active Referral for Expectant Fathers Who Smoke Cigarettes

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