Globally 72.5% of pregnant women are daily smokers, of whom 13.5% smoke heavily. [1] Cigarette smoking and excessive maternal drinking during pregnancy are associated with increased numbers of stillbirths and sudden unexpected deaths. [2,3] In addition, environmental exposure to cigarette smoke is associated with increased numbers of stillbirths and congenital abnormalities, and lower birthweights. [4] Maternal alcohol intake prior to and during pregnancy is also associated with increased numbers of stillbirths and an increase in preterm labour and babies with lower birthweights. [5,6] ObjectivesIt is therefore essential to do as much as possible to reduce the risk of exposure to cigarette smoke and alcohol during pregnancy. During the Safe Passage Study (SPS) by the PASS (Perinatal Alcohol, SIDS, Stillbirth) Network, pregnant women were recruited at an antenatal clinic in the community where women at low risk for complications of pregnancy book for antenatal care. [7] At enrolment in the study, the utmost care was taken to advise all participants about the adverse effects of smoking and/or drinking during pregnancy. As enrolment in the study extended over 7.5 years, many participants were recruited again during their next or even a subsequent pregnancy. Comparison of smoking and drinking habits between pregnancies could give an indication of the effectiveness of the information about the adverse effects of smoking and drinking provided during previous pregnancies. Smoking and drinking patterns during the first enrolment in the study were therefore compared with those during the second and third enrolments of the same participants. MethodsAt recruitment, the purpose of the study and the need for informed consent were carefully explained to potential participants. Each participant received a signed copy of the consent form in Afrikaans or English (the two languages of the study community).Research staff were specifically trained in the study procedures prior to initiation of the study, and throughout its course. Care was taken to inform participants about the dangers of smoking and drinking during pregnancy. They were also given pamphlets in their own language on these topics and a list of telephone numbers This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

No abstract

No abstract

No abstract

No abstract