Abstract
Tobacco is still a leading cause of premature death and morbidity. Particular attention has been given to pregnant women due to the scientific evidence on the importance of early life exposures for disease onset later in life. The purpose of this study was to assess smoking prevalence, smoking cessation rate and environmental tobacco smoke (ETS) exposure, and the role of socioeconomic position (SEP) on these behaviors among pregnant women. Cross-sectional data of 619 pregnant women, aged between 18 and 46 years, from Porto Metropolitan Area, Portugal, on current smoking, ETS exposure and SEP indicators was collected, face-to-face, using a questionnaire filled in during a personal interview at the postpartum hospital stay. The smoking prevalence, and ETS exposure among non-smokers before pregnancy was 27.6% and 57.4%, respectively. 4.1% of the participants reported to have stopped smoking before pregnancy, whereas about 41% quitted along pregnancy, resulting in a smoking prevalence at birth of 14.6%. Exposure to ETS also decreased throughout pregnancy to 49.8% at birth. Lower educational level was significantly associated with both higher smoking prevalence and exposure to ETS and lower smoking cessation. This study demonstrates that smoking and ETS exposure during pregnancy remains high, and that there are still significant socioeconomic inequalities in smoking; thus tobacco-focused preventive interventions need to be reinforced.
Highlights
Tobacco is still a leading cause of premature death and morbidity
In Portugal, daily smoking remains higher in men than in women, even though prevalence has been decreasing in men (28.8% in 2005 and 26.7% in 2014) and increasing in women (11.3% and 14.6% in 2005 and 2014, respectively)[4], these trends are expected to maintain in the years, in some countries, diminishing the differences observed between s exes[1]
Understanding the trends and determinants of these behaviors is crucial for the development of effective preventive interventions that aim to reduce the associated burden of disease
Summary
Tobacco is still a leading cause of premature death and morbidity. Particular attention has been given to pregnant women due to the scientific evidence on the importance of early life exposures for disease onset later in life. Soon after the recognition of the health effects related to smoking, it has become evident that exposure to environmental tobacco smoke (ETS) constitutes a health risk factor[5] and that there is no secure threshold of exposure[6] For this reason, ETS was classified as carcinogenic for humans (group 1) in 2012 by the International Agency for Research on C ancer[7]. Portugal was one of the countries that signed the WHO Framework Convention on Tobacco Control, leading to the implementation of the anti-smoking law in all enclosed public spaces, the 37/2007 law[10], in 2008 This law contained a new framework to protect individuals from ETS, and to encourage cutting down/quitting smoking
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