Social-environmental factors related to prenatal smoking

Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, USA.
Addictive behaviors (Impact Factor: 2.76). 09/2011; 37(1):73-7. DOI: 10.1016/j.addbeh.2011.09.001
Source: PubMed


Cigarette smoking during pregnancy is a significant public health issue that has profound effects on maternal and fetal health. Although many women stop smoking upon pregnancy recognition, a large number continue. Given the higher burden of smoking among low-income women, the focus of this study is to examine the impact of pre-conception social-environmental influences on smoking cessation during the first trimester of pregnancy.
Pregnant women who presented for prenatal were asked to complete a screening form at their first prenatal appointment. Women who agreed to participate were scheduled for a total of four interviews; a prenatal interview at the end of each trimester and a postnatal interview at 2 months of infant age. The sample for the current report consisted of pregnant women (first trimester) with a partner (N=316).
After controlling for pre-conception heaviness of smoking, a number of social-environmental factors were associated with smoking during the first trimester. Women were more likely to smoke during the first trimester if their partner was a smoker; however, the presence of other household smokers was not associated with increased risk for smoking. Additionally, women with a greater proportion of friends (but not relatives) who smoked and more frequent exposure to environmental tobacco were more likely to smoke.
This work found differential impacts of the social network on smoking suggesting that understanding relationship type, not simply number of smokers, may be important for smoking cessation efforts. Understanding differences in social network influences on smoking can help to inform interventions.

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Available from: Lynn T Kozlowski
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    • "Compared to non-smoking women, women who smoke during pregnancy have lower education and socioeconomic status, are younger, are more often single, and display more psychopathology, both in adulthood and in youth (Knopik 2009; Rogers 2009; Roza et al. 2008; Tong 2009; Kodl and Wakschlag 2004). In addition, mothers who smoked during pregnancy tend to have a partner who smoked as well (Boomsma et al. 1994; Homish et al. 2012). Paternal SDP has been related to lower educational attainment and hazardous drinking (Everett et al. 2007). "
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    ABSTRACT: Maternal smoking during pregnancy (SDP) is associated with increased risk of externalizing and internalizing behaviors in offspring. Two explanations (not mutually exclusive) for this association are direct causal effects of maternal SDP and the effects of genetic and environmental factors common to parents and offspring which increase smoking as well as problem behaviors. Here, we examined the associations between parental SDP and mother rated offspring externalizing and internalizing behaviors (rated by the Child Behavior Checklist/2-3) at age three in a population-based sample of Dutch twins (N = 15,228 pairs). First, as a greater effect of maternal than of paternal SDP is consistent with a causal effect of maternal SDP, we compared the effects of maternal and paternal SDP. Second, as a beneficial effect of quitting smoking before pregnancy is consistent with the causal effect, we compared the effects of SDP in mothers who quit smoking before pregnancy, and mothers who continued to smoke during pregnancy. All mothers were established smokers before their pregnancy. The results indicated a greater effect of maternal SDP, compared to paternal SDP, for externalizing, aggression, overactive and withdrawn behavior. Quitting smoking was associated with less externalizing, overactive behavior, aggression, and oppositional behavior, but had no effect on internalizing, anxious depression, or withdrawn behavior. We conclude that these results are consistent with a causal, but small, effect of smoking on externalizing problems at age 3. The results do not support a causal effect of maternal SDP on internalizing behaviors.
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    • "Research has established that SHS increases childhood morbidity and mortality from respiratory infections. Yet, understanding that SHS adversely affects children’s respiratory health does not provide detail about specific factors that may lead to exposure and result in acute lower respiratory conditions [10-12]. "
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    ABSTRACT: Background The impact of secondhand smoke (SHS) on Southeast Asian children’s health has been assessed by a limited number of studies. The purpose of this study was to determine whether in Thailand, pre- and postnatal exposure to SHS is associated with acute lower respiratory conditions in young children. Methods We conducted a case control study of 462 children under age five admitted with acute lower respiratory illnesses, including asthma and pneumonia, at a major hospital in Bangkok. We selected 462 comparison controls from the well-child clinic at the hospital and matched them by sex and age. We used a structured questionnaire to collect information about exposure to SHS and other factors. We conducted bivariate and multivariate analyses to identify risk factors for acute lower respiratory conditions. Results The number of cigarettes smoked at home per day by household members was significantly greater among cases. A greater number of household caregivers of cases held and carried children while smoking as compared to controls (26% versus 7%, p <0.05). Cases were more likely to have been exposed to SHS in the household (adjusted OR = 3.82, 95% CI = 2.47-5.9), and outside (adjusted OR = 2.99, 95% CI = 1.45-6.15). Parental lower educational level and low household income were also associated with respiratory illnesses in Thai children under five. Conclusions Thai children who are exposed to SHS are at nearly 4 times greater risk of developing acute lower respiratory conditions. Continued effort is needed in Thailand to eliminate children’s exposure to SHS, especially at home.
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