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: 2.43). 03/2010; 89(4):454-64. DOI: 10.3109/00016341003605719
Source: PubMed


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.

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    • "These diseases include destructive periodontitis (Cutress, 2003; Gupta et al., 2003; Gupta et al., 2013); oral and oropharyngeal cancers (Johnson et al., 2011; Radoi et al.; 2013); oral potentially malignant disorders, notably leukoplakia, erythroplakia, and oral submucous fibrosis (Warnakulasuriya et al., 2007) and cardiovascular disorders including stroke (Gupta et al., 2013). Other significant health disorders associated with tobacco consumption include erectile dysfunction (Wang et al., 2013) and problems in pregnancy, including stillbirth and low birth weight babies (Wisborg et al., 2001; England et al., 2010). 1 RESEARCH ARTICLE A Cross-Country Comparison of Knowledge, Attitudes and Practices about Tobacco Use: Findings from the Global Adult Tobacco Survey "
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    ABSTRACT: Background: Knowledge and individual perceptions about adverse effects of all forms of tobacco exert direct influence on the level of tobacco consumption in various socio-demographic groups. The objective of this study was to determine the nature, extent and demographic correlates of knowledge, attitudes and perceptions of use of tobacco among adults in low and middle income countries. Materials and methods: The Global Adult Tobacco Survey, conducted in fourteen different countries from 2008-2010, was sourced for the data analyzed in this study. Descriptive statistical analyses were conducted to determine the prevalent knowledge and individual perceptions amongst adults about all forms of tobacco consumption. Results: There was relatively high awareness about the harmful effects of smoking tobacco with main awareness being about its relationship with lung cancer (>90% in most countries). In contrast, there was relatively low awareness about harmful effects of smokeless tobacco (< 90% in all countries except India and Bangladesh), and observed correlations of smoking tobacco with heart attacks (40.6% in China, 65.1% in India) and stroke (28.2% in China, 50.5% in India). Conclusions: A large proportion of adults living in low and middle income countries possess adequate knowledge about smoking tobacco but have inadequate awareness as well as false perceptions about smokeless forms of tobacco. Popular beliefs of inverse relationships of tobacco consumption with knowledge, attitudes and perception of populations towards tobacco are challenged by the findings of this study.
    Asian Pacific journal of cancer prevention: APJCP 06/2014; 15(12):5035-42. DOI:10.7314/APJCP.2014.15.12.5035 · 2.51 Impact Factor
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    • "This has led to increased concern about the adverse effects of tobacco use during pregnancy (Anderka et al., 2010). Maternal smoking has been found to be a marker for large increases in risk for multiple adverse outcomes, including fetal mortality, stillbirth, infant and child mortality, preterm birth and morbidity (Cnattingius, 2004; England et al., 2010). While a review of the link between maternal smoking and adverse events during pregnancy is beyond the scope of this paper, maternal smoking is a huge risk factor for maternal and child health worldwide (Cnattingius, 2004). "
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    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(1):105-111. DOI:10.7895/ijadr.v3i1.131
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    • "Betel quid (with and without tobacco) is the most commonly used product among South Asians (NHS Health and Social Care Information Centre, Public Health Statistics, 2005). ST is associated with a number of health problems including nicotine addiction (SCENIHR, 2008), mouth and oral cancer (Critchley & Unal, 2003), oral pain (Pau et al., 2003), myocardial infarction, stroke (Boffetta & Straif, 2009), loss in bone density (Quandt, Spangler, Case, Bell, & Belflower, 2005), problems during pregnancy and following childbirth (including stillbirth and lower birth weight) (England et al., 2010; Gupta & Sreevidya, 2004), and late diagnosis of dental problems (West, McNeill, & Raw, 2004). Despite the health risk associated with ST use, many products such as gutkha and pan masala, which are widely used by the South Asian community within "
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    ABSTRACT: Introduction: Certain types of smokeless tobacco (ST) are popular among some people of South Asian origin in England; however, little is known about the contextual factors surrounding use in this population. This systematic review explores the factors associated with ST use among people of South Asian origin in England. Methods: An iterative search strategy in targeted databases and grey literature sources was conducted in the summer of 2011. Data extractions and quality assessments were completed and verified by two reviewers, and results were presented as a narrative. Results: A total of 2,968 references were screened by two reviewers who agreed on the inclusion of 14 studies. ST use is more prevalent among older participants who may have started chewing in India; however, the evidence suggests that some younger English-born South Asians are using ST as well. Reasons for chewing included the use of these products in times of stress, boredom or simply to relax. Traditional health messages and prior held beliefs may lead them to chew these products because of misconceptions about their health benefits, since very few people were aware of the health risks. Many expressed a desire to quit, however found it difficult to go without ST. Conclusion: This review examines the complex factors that underpin and influence ST use among South Asians in England with the potential of informing targeted interventions and health policy.
    Nicotine & Tobacco Research 10/2012; 15(5). DOI:10.1093/ntr/nts193 · 3.30 Impact Factor
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