Advertisement

Canadian Journal of Public Health

, Volume 94, Issue 4, pp 297–299 | Cite as

Stopping Smoking During Pregnancy

Are We on the Right Track?
  • J. Michael Paterson
  • Ieva M. Neimanis
  • Eileen Bain
Article

Abstract

Background

Recent data suggest that although smoking during pregnancy has declined in North America, this has more to do with falling rates of smoking initiation among women of childbearing age than with increased rates of pregnancy-related smoking cessation. One possible explanation is poor exposure to effective stop-smoking strategies. Better information about women who smoke during pregnancy may help target these interventions more effectively.

Methods

The study was a cross-sectional, self-administered survey of a consecutive sample of 916 (40.4% of eligible) women who delivered healthy babies in 1997–98 at a tertiary teaching hospital in Hamilton, Ontario. Our main focus was on health behaviours (smoking, drinking, eating, and exercise habits) before and during pregnancy; but we also included questions about the presence of (other) children and (other) smokers in the household, perceived health status, the subject’s age and level of education, and whether or not the present pregnancy was planned. Factors associated with pregnancy-related smoking cessation were identified using multiple logistic regression.

Results

Respondents were better educated and healthier, but smoked at rates similar to women of childbearing age in Hamilton at the time of the survey. Two thirds of prior smokers or 20% of respondents overall continued to smoke during pregnancy. After adjustment for other factors, three factors were associated with ongoing smoking during pregnancy: having other smokers in the household; having other children in the household; and not having post-secondary education.

Conclusions

Many pregnant smokers are not being reached by current stop-smoking strategies. New ways to help these women and their partners are needed.

Résumé

Contexte

Selon des données récentes, si le tabagisme durant la grossesse est en baisse en Amérique du Nord, c’est plutôt parce que moins de femmes en âge de procréer se mettent à fumer qu’en raison d’une augmentation des taux de renoncement au tabac durant la grossesse. Une explication possible serait la piètre exposition à des stratégies antitabac efficaces. Une meilleure information sur les femmes qui fument durant la grossesse pourrait contribuer à mieux cibler de telles mesures.

Méthode

Dans cette étude transversale, un échantillon consécutif de 916 femmes (40,4 % de la population admissible) ayant donné naissance à des bébés en santé en 1997–1998 dans un hôpital d’enseignement de soins tertiaires à Hamilton (Ontario) a rempli un questionnaire d’auto-évaluation portant principalement sur les comportements liés à la santé (tabagisme, consommation d’alcool, alimentation et exercice) avant et durant la grossesse, mais comportant aussi des questions sur la présence d’(autres) enfants et d’(autres) fumeurs dans le ménage, sur l’état de santé subjectif, sur l’âge et le niveau d’instruction du sujet et sur le fait que la grossesse en cours ait été planifiée ou non. Les facteurs associés au renoncement au tabac durant la grossesse ont été cernés par régression logistique multiple.

Résultats

Les répondantes étaient mieux instruites et en meilleure santé que l’ensemble des femmes en âge de procréer vivant à Hamilton au moment de l’enquête, mais leurs taux de tabagisme étaient semblables. Les deux tiers des anciennes fumeuses (20 % de l’ensemble des répondantes) ont continué à fumer durant leur grossesse. Après rajustement selon d’autres facteurs, nous avons relevé trois facteurs associés au maintien du tabagisme durant la grossesse: la présence d’autres fumeurs dans le ménage; la présence d’autres enfants dans le ménage; et l’arrêt des études après le secondaire.

Conclusion

De nombreuses fumeuses enceintes ne sont pas touchées par les stratégies antitabac actuelles. Il faudrait trouver de nouvelles façons d’aider ces femmes et leurs partenaires.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Tough SC, Svenson LW, Johnston DW, Schopflocher D. Characteristics of preterm delivery and low birthweight among 113,994 infants in Alberta: 1994–1996. Can J Public Health 2001;92:276–80.PubMedGoogle Scholar
  2. 2.
    Orleans CT, Johnson RW, Barker DC, Kaufman NJ, Marx JF. Helping pregnant smokers quit: Meeting the challenge in the next decade. Western J Med 2001;174:276–81.CrossRefGoogle Scholar
  3. 3.
    Stewart PJ, Potter J, Dulberg C, Niday P, Nimrod C, Tawagi G. Change in smoking prevalence among pregnant women 1982–93. Can J Public Health 1995;86:37–41.Google Scholar
  4. 4.
    Ebrahim S, Floyd RL, Merrit RK, Decoufle P, Holtzman D. Trends in pregnancy-related smoking rates in the United States, 1987–1996. JAMA 2000;283:361–66.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Husten CG, Chrismon JH, Reddy MN. Trends and effects of cigarette smoking among girls and women in the United States, 1965–1993. J Am Med Women’s Association 1996;51:11–18.Google Scholar
  6. 6.
    US Department of Health and Human Services. Healthy People 2000 Review. Washington, DC: Office of Disease Prevention and Health Promotion; 1998–1999. DHHS publication (PHS) 99–1256.Google Scholar
  7. 7.
    Connor SK, McIntyre L. The sociodemographic predictors of smoking cessation among pregnant women in Canada. Can J Public Health 1999;90:352–55.Google Scholar
  8. 8.
    Dodds L. Prevalence of smoking among pregnant women in Nova Scotia from 1988 to 1992. CMAJ 1995;152:185–90.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Neimanis IM, Paterson JM, Bain E. Preventing neural tube defects. Survey of preconceptional use of folic acid. Can Fam Phys 1999;45:1717–22.Google Scholar
  10. 10.
    Personal communication: Cloutier Fisher D, Central West Health Planning Information Network, November 1999.Google Scholar
  11. 11.
    Cnattingius S, Lindmark G, Meirik O. Who continues to smoke while pregnant? J Epidemiol Community Health 1992;46:218–21.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Naylor P-J, Adams JS, McNeil D. Facilitating changes in perinatal smoking: The impact of a stage-based workshop for care-providers in British Columbia. Can J Public Health 2002;93:285–90.PubMedGoogle Scholar
  13. 13.
    Melvin CL, Dolan-Mullen P, Windsor PA, Whiteside HP, Goldenberg RL. Recommended cessation counselling for pregnant women who smoke: A review of the evidence. Tobacco Control 2000;9(Suppl 3):III80–4.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Ontario Medical Association. Rethinking stop-smoking medication: Myths and facts. Toronto, ON: Ontario Medical Association, June 1999. Accessed July 2001 at: https://doi.org/www.oma.org/phealth/stopsmoke.htm.Google Scholar
  15. 15.
    Wisborg K, Henriksen TB, Jespersen LB, Secher NJ. Nicotine patches for pregnant smokers: A randomised controlled study. Obstetrics and Gynecology 2000;96:967–71.PubMedGoogle Scholar
  16. 16.
    Dempsey DA, Benowitz NL. Risks and benefits of nicotine to aid smoking cessation in pregnancy. Drug Safety 2001;24:277–322.CrossRefPubMedGoogle Scholar
  17. 17.
    GlaxoSmithKline. The Bupropion Pregnancy Registry: Interim Report (1 September 1997 through 28 February 2001). Wilmington, NC: GlaxoSmithKline, June 2001. Accessed October 2001 at: 1-800-336-2176.Google Scholar

Copyright information

© The Canadian Public Health Association 2003

Authors and Affiliations

  • J. Michael Paterson
    • 1
    • 4
  • Ieva M. Neimanis
    • 1
    • 2
  • Eileen Bain
    • 3
  1. 1.Department of Family MedicineSt. Joseph’s HealthcareHamiltonCanada
  2. 2.Department of Family MedicineMcMaster UniversityHamiltonCanada
  3. 3.Maternal-Newborn ProgramSt. Joseph’s HealthcareCanada
  4. 4.Family Medicine Research OfficeHamiltonCanada

Personalised recommendations