Spatial Relations Between Tobacco Pipe Use and Infant Mortality in Cambodia

Abstract

PP-31-048 Background/Aims: Tobacco smoke is a major indoor air pollutant in industrialized and developing nations. Links have been found between prenatal maternal smoking and adverse health effects as well as between children's environmental tobacco smoke (ETS) exposure and adverse outcomes. The Southeast Asia and Western Pacific regions hold half of the world's children, and Cambodia has one of the highest prevalences of smoking worldwide. This study examined the relationship between tobacco pipe use and premature deaths of children born to Cambodian women. Methods: Multivariate logistic regression using SAS 9.2 and SUDAAN was applied in observing relationships between the prevalence of infant deaths and the mother's exposure to ETS. ArcGIS 9.2 was used to visually represent the findings. Results: This study showed no statistically significant relationship between prenatal exposure to ETS and infant deaths within the first year of life. The OR for combined ETS exposure (ie home, work, public place) was 0.91 (0.71–1.18), P = 0.48. ORs for home, work, and public place were each 1.00. GIS mapping showed that Rotana Kiri had high water pipe use, high ETS, and high infant mortality. Conclusion: Several components were not considered but may have influenced the observed results. These factors include the use of household wood-burning fires and stoves, and medical conditions of the mother, such as lupus, diabetes, and HIV/AIDS. This study also yielded findings that warrant further investigation. GIS maps showed higher numbers of chewing tobacco users within central provinces of Cambodia. Additionally, there were areas with higher infant deaths and fewer tobacco users. Further analyses may offer insight on these observations and determine what constituents contributed to the mortalities. Highest infant mortality, highest ETS, and water-pipe all occurred in Rotana Kiri. Although there was no national association, there may be an important spatial association between ETS and water-pipe use across Cambodia.