Abstract
Argentina and Uruguay have a high prevalence of smoking during pregnancy, as well as of secondhand smoke (SHS) exposure. In this secondary analysis of a trial to implement brief smoking cessation counseling during antenatal care in Argentina and Uruguay, we aim to evaluate the effects of the intervention on the rates of self-reported SHS exposure at home and at work, and on attitudes recalled by non-smoker women enrolled in the intervention group compared with the control group. We randomly assigned (1:1) 20 antenatal care clusters in Argentina and Uruguay to receive a multifaceted intervention to implement brief smoking cessation counseling, which also included questions and counseling regarding SHS exposure, or to receive the standard of care. There was not a statistically significant difference between groups of the intervention’s effect (reduction of exposure to SHS) on any of the three exposure outcome measures (exposure at home, work or other indoor areas) or on the attitudes of women regarding exposure (avoiding breathing SHS and having rooms where smoking is forbidden). This analysis shows that we should not expect reductions in SHS exposure with this modest intervention alone. To achieve such reductions, strategies engaging partners and other household members may be more effective.
Highlights
Secondhand smoke (SHS) exposure during pregnancy is associated with many adverse outcomes for both the mother and the newborn [1,2]
We aim to evaluate the effects of the multifaceted intervention on the rates of secondhand smoke (SHS) exposure at home and at work recalled by women enrolled in the intervention group compared to the control group
SHS, andwere wereclassified classifiedas asnon-smokers non-smokers or period were analyzed in women from the intervention group and in women from the control group
Summary
Secondhand smoke (SHS) exposure during pregnancy is associated with many adverse outcomes for both the mother and the newborn [1,2]. Pregnant women exposed to SHS are 16% more likely to have a low-birth-weight baby [3,4], 20% more likely to have a preterm birth [5] and 23% more likely to suffer a stillbirth [5,6]. Offspring experience adverse health effects when mothers are exposed to SHS during pregnancy [7,8,9,10]. Exposure to SHS is high in southern Latin American countries [11]. A recent study conducted in Argentina and Uruguay reported that in both countries, 35.9% of pregnant women are exposed to SHS at home, work or in public places [12]. World Health Organization (WHO) guidelines released in 2013 strongly recommend that antenatal care (ANC) providers, at minimum, screen all pregnant women for both tobacco use and SHS exposure, provide brief tobacco cessation counseling, provide education regarding the harms of SHS and offer
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