Non-cigarette tobacco use among women and adverse pregnancy outcomes

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30030, USA.
Acta Obstetricia Et Gynecologica Scandinavica (Impact Factor: 1.99). 03/2010; 89(4):454-64. DOI: 10.3109/00016341003605719
Source: PubMed

ABSTRACT Although cigarette smoking remains the most prevalent form of tobacco use in girls and in women of reproductive age globally, use of non-cigarette forms of tobacco is prevalent or gaining in popularity in many parts of the world, especially in low- and middle-income countries. Sparse but growing evidence suggests that the use of some non-cigarette tobacco products during pregnancy increases the risk of adverse pregnancy outcomes. In this paper we review the literature on the prevalence of non-cigarette tobacco product use in pregnant women and in women of reproductive age in high-, middle-, and low-income countries and the evidence that maternal use of these products during pregnancy has adverse health effects. In addition, we communicate findings from an international group of perinatal and tobacco experts that was convened to establish research priorities concerning the use of non-cigarette tobacco products during pregnancy. The working group concluded that attempts to develop a public health response to non-cigarette tobacco use in women are hindered by a lack of data on the epidemiology of use in many parts of the world and by our limited understanding of the type and magnitude of the health effects of these products. We highlight research gaps and provide recommendations for a global research agenda.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Aims: Development of useful estimates of rates of maternal smoking during pregnancy, and the impact of smoking on rates and duration of maternal alcohol use during pregnancy. Design: A prospective study utilizing systematic screening of consecutive pregnant women. Setting: Ten prenatal care sites in Brazzaville, Congo's largest city, where 50% of live births in the Congo occur. Women were asked to report the number of cigarettes smoked per day. Findings: From the 10 sites, 3,099 women were screened and 5.5% (n = 172) reported smoking. The mean number of cigarettes smoked per day was 1.1 and only 11% (n = 19) of the women reported smoking two or more cigarettes per day during pregnancy. Smoking during pregnancy was associated with a 4.9-fold increase in prenatal alcohol exposure during pregnancy. We found that 93% of the women who smoked also used alcohol during pregnancy. Conclusions: While the prevalence of smoking and the average number of cigarettes smoked per day were both low, smoking at any level results in a huge increase in risk for maternal alcohol use during pregnancy. The trend across the developing world is for increasing rates of smoking among women and children. Since the number of cigarettes smoked per day was low, smoking cessation programs and public health warnings may be useful in further reducing rates of smoking during pregnancy and, thus, risk for prenatal alcohol exposure in the Congo. We believe this is the first report quantifying the risk of smoking and prenatal alcohol use in a population of pregnant women.
    03/2014; 3:105-111. DOI:10.7895/ijadr.v3i1.131
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although smokeless tobacco (SLT) use is prevalent in South Asian countries including Bangladesh, information about the pattern and correlates of SLT use is scarce. This study described the pattern and predictors of SLT use among Bangladeshi adults.
    PLoS ONE 07/2014; 9(7):e101934. DOI:10.1371/journal.pone.0101934 · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Worldwide, use of tobacco is viewed as an important threat to the health of pregnant women and their children. However, the extent of tobacco use in pregnant women in low-income and middle-income countries (LMICs) remains unclear. We assessed the magnitude of tobacco use in pregnant women in LMICs. Methods We used data from Demographic and Health Surveys (DHS) done in 54 LMICs between Jan 1, 2001, and Dec 1, 2012, comprising 58 922 pregnant women (aged 15–49 years), which were grouped by WHO region. Prevalence of current tobacco use (smoked and smokeless) was estimated for every country. Pooled estimates by regions and overall were obtained from random-effects meta-analysis. Findings Pooled prevalence of any tobacco use in pregnant women in LMICs was 2·6% (95% CI 1·8–3·6); the lowest prevalence was in the African region (2·0%, 1·2–2·9) and the highest was in the Southeast Asian region (5·1%, 1·3–10·9). The pooled prevalence of current tobacco smoking in pregnant women ranged from 0·6% (0·3–0·8) in the African region to 3·5% (1·5–12·1) in the Western Pacific region. The pooled prevalence of current smokeless tobacco use in pregnant women was lowest in the European region (0·1%, 0·0–0·3) and highest in the Southeast Asian region (2·6%, 0·0–7·6). Interpretation Overall, tobacco use in pregnant women in LMICs was low; however high prevalence estimates were noted in some LMICs. Prevention and management of tobacco use and exposure to second-hand smoke in pregnancy is crucial to protect maternal and child health in LMICs. Funding None.
    09/2014; 2(9):e513–e520. DOI:10.1016/S2214-109X(14)70283-9


Available from
May 29, 2014