Smoking in Pregnancy Among Indigenous Women in High-Income Countries: A Narrative Review

Gould, Gillian Sandra; Patten, Christi A.; Glover, Marewa; Kira, Anette; Jayasinghe, Harshani

doi:10.1093/ntr/ntw288

Cited by 42 publications

(57 citation statements)

References 86 publications

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“…Tobacco use during pregnancy is an important public health issue worldwide [1][2][3]. The adverse effects of cigarette smoking during pregnancy and after delivery on maternal, fetal, and infant health are well documented [4].…”

Section: Introductionmentioning

confidence: 99%

The Healthy Pregnancies Project: Study protocol and baseline characteristics for a cluster-randomized controlled trial of a community intervention to reduce tobacco use among Alaska Native pregnant women

Patten

Lando²,

Desnoyers

et al. 2019

Contemporary Clinical Trials

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A B S T R A C TBackground: Tobacco use prevalence is high among pregnant Alaska Native (AN) women but few interventions have been evaluated for this group. The Healthy Pregnancies Project aims to evaluate a multicomponent intervention for reducing tobacco use during pregnancy and the postpartum period among AN women. This report describes the study protocol and participant baseline characteristics. Design: Cluster-randomized controlled trial with village as the unit of assignment. Sixteen villages in rural southwest Alaska were stratified on village size and randomized to a multicomponent intervention (n = 8 villages) or usual care (n = 8 villages). Methods: Pregnant AN women from the study villages were enrolled. All participants receive the usual care provided to pregnant women in this region. Participants from intervention villages additionally receive individual phone counseling on healthy pregnancies plus a social marketing campaign targeting the entire community delivered by local AN "Native Sisters." Baseline measurements for all enrolled pregnant women have been completed. Follow-up assessments are ongoing at delivery, and at 2 and 6 months postpartum. The primary outcome is biochemically verified tobacco use status at 6 months postpartum. Results: Recruitment was feasible with 73% of eligible women screened enrolled. The program reached more than half (56%) of AN pregnant women from the study villages during the recruitment period. Participants are N = 352 pregnant AN women, 188 enrolled from intervention villages and 164 from control villages. At baseline, participants' mean (SD) age was 25.8 (5.0) years, they were at 26.8 (9.8) weeks gestation, and 66.5% were current tobacco users.

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Section: Introductionmentioning

confidence: 99%

The Healthy Pregnancies Project: Study protocol and baseline characteristics for a cluster-randomized controlled trial of a community intervention to reduce tobacco use among Alaska Native pregnant women

Patten

Lando²,

Desnoyers

et al. 2019

Contemporary Clinical Trials

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“…Adolescents, Indigenous and less educated women are least likely to reduce or stop smoking in pregnancy. 12,13 The objective of this study was to evaluate the obstetric and perinatal consequences of smoking during pregnancy from a large cohort of women birthing at a tertiary Australian perinatal centre.…”

Section: Introductionmentioning

confidence: 99%

The burden of adverse obstetric and perinatal outcomes from maternal smoking in an Australian cohort

Lodge

Flatley

et al. 2018

Aust NZ J Obst Gynaeco

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“…22 Similarly, more Indigenous pregnant women in these high-income countries smoke than do their nonindigenous counterparts. 23 More than three times the number of pregnant Indigenous women in Australia smoke compared with their nonindigenous counterparts (47% vs 13%). 24 Similarly high figures exist in Native Americans and Alaska Natives (26%), Canadian First Nations populations (18%-90%), and New Zealand Maori (34%) women during pregnancy.…”

Section: Prevalence Of and Factors Predisposing To Tobacco Use Amongmentioning

confidence: 99%

“…24 Similarly high figures exist in Native Americans and Alaska Natives (26%), Canadian First Nations populations (18%-90%), and New Zealand Maori (34%) women during pregnancy. 23 Alaska Native women also report a high prevalence of prenatal smokeless tobacco use, with 56% to 60% use observed for women in rural southwest Alaska. Little is known about the prevalence of the use of electronic nicotine devices (ENDs) by Indigenous women.…”

Section: Prevalence Of and Factors Predisposing To Tobacco Use Amongmentioning

confidence: 99%

“…Little is known about the prevalence of the use of electronic nicotine devices (ENDs) by Indigenous women. 23 Maternal smoking rates are much higher in lower socioeconomic groups (characterized by low income, low levels of educational attainment, and high unemployment rates). 25 Lower socioeconomic status for women is also associated with more psychological and emotional problems, less social support, and less residential stability.…”

Section: Prevalence Of and Factors Predisposing To Tobacco Use Amongmentioning

confidence: 99%

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Prevention and Treatment of Smoking and Tobacco Use During Pregnancy in Selected Indigenous Communities in High-Income Countries of the United States, Canada, Australia, and New Zealand

Gould

Lim

Mattes

2017

Chest

Self Cite

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Tobacco smoking during pregnancy is the most important modifiable risk factor for adverse pregnancy outcomes and long-term health complications for mother and baby. Tobacco use during pregnancy has decreased in high-income countries but not in Indigenous women in Australia, New Zealand, the United States, and Canada. This evidence-based review focuses on tobacco use among Indigenous pregnant women in high-income countries that share a history of European colonization. Indigenous women are more likely to use tobacco because of socioeconomic disadvantage, social norms, and poor access to culturally appropriate tobacco cessation support. Complications arising from tobacco smoking during pregnancy, such as low birth weight, prematurity, perinatal death, and sudden infant death syndrome, are much higher in Indigenous populations. Effective approaches to cessation in pregnant nonindigenous women involves behavioral counseling, with or without nicotine replacement therapy (NRT). Higher nicotine metabolism during pregnancy and poor adherence may affect therapeutic levels of NRT. Only two randomized trials were conducted among Indigenous women: neither found a statistically significant difference in cessation rates between the treatment and comparison arms. Considerations should be given to (1) whole life course approaches to reduce tobacco use in Indigenous women, (2) prohibiting tobacco promotion and reducing access to alcohol for minors to prevent smoking initiation in Indigenous youth, and (3) training health-care professionals in culturally appropriate smoking cessation care to improve access to services. It is critical to ensure acceptability and feasibility of study designs, consult with the relevant Indigenous communities, and preempt implementation challenges. Research is needed into the effect of reducing or stopping smoking during pregnancy when using NRT on subsequent maternal and infant outcomes.

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Smoking in Pregnancy Among Indigenous Women in High-Income Countries: A Narrative Review

Cited by 42 publications

References 86 publications

The Healthy Pregnancies Project: Study protocol and baseline characteristics for a cluster-randomized controlled trial of a community intervention to reduce tobacco use among Alaska Native pregnant women

The Healthy Pregnancies Project: Study protocol and baseline characteristics for a cluster-randomized controlled trial of a community intervention to reduce tobacco use among Alaska Native pregnant women

The burden of adverse obstetric and perinatal outcomes from maternal smoking in an Australian cohort

Prevention and Treatment of Smoking and Tobacco Use During Pregnancy in Selected Indigenous Communities in High-Income Countries of the United States, Canada, Australia, and New Zealand

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