Importance of exposure to gaseous and particulate phase components of tobacco smoke in active and passive smokers

CONTEXT: Cigarette smoke, whether inhaled voluntarily or not, causes damage to the mother-infant pair. The antenatal period may present the best opportunity for performing effective anti-smoking campaigns. OBJECTIVE: To study the obstetric and perinatal effects of smoking on pregnancy and the infant. TYPE OF STUDY: Prospective study, interviewing pregnant women who were randomly selected at the maternity hospital as they were being discharged after giving birth. SETTING: Hospital Municipal Vereador José Storópolli, São Paulo, Brazil. METHODS: 758 patients were interviewed regarding smoke inhalation before being discharged from the maternity hospital. The groups were formed by 42 active smokers, 272 passive smokers, 108 who inhaled smoke both actively and passively, and 336 non-smokers. The groups were compared regarding age, parity, school education, incidence of spontaneous abortion, rate of caesarian births, average gestational age at birth, rate of low birth weight and adequacy of weight in relation to the gestational age of newborn infants. For all variables we considered p < 0.05 as statistically significant. RESULTS: There was a high rate (55.7%) of pregnant smokers, including 5.5% active, 35.9% passive and 14.3% active-passive smokers. Active and active-passive smokers were older and had higher parity. Active smokers had lower education levels and higher rates of previous spontaneous abortion. The weights of newborn babies were lower for smoking mothers. DISCUSSION: The study was performed among patients that were mostly of low economic, social and cultural levels, thus possibly explaining the high incidence of smokers. Worse still was that 35.9% of the non-smokers were actually passive smokers. These rates we report were similar to those from the literature. The typical receptiveness of teenage girls to unrestricted advertising in the media contributes towards an early start to acquiring the habit of smoking, including during pregnancy in our country. We emphasize the difficulties in quantifying exposure to cigarettes even among active smokers. CONCLUSIONS: Cigarette smoke, whether inhaled voluntarily or not, has an unfavorable effect on the mother-infant pair.

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“…[11][12][13] Cigarette smoke acts in two ways: centrally and peripherally. Central action occurs when the smoker inhales on the cigarette.…”

Section: Discussionmentioning

confidence: 99%

Obstetric and perinatal effects of active and/or passive smoking during pregnancy

Nakamura¹,

Alexandre²,

Santos³

et al. 2004

Sao Paulo Med. J.

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“…Studies have shown that exposure to biofuels is associated with COHb levels of 2.5-13% (16,17), covering the range seen for passive through heavy active smoking (18,19). It is therefore not unreasonable to expect that the effect of passive smoking on birth weight would also apply to pregnant women habitually exposed to high levels of biofuel smoke, as is the case in developing countries (20,21).…”

Section: Tobacco Smoke Biofuels and Low Birth Weightmentioning

confidence: 99%

Birth weight and exposure to kitchen wood smoke during pregnancy in rural Guatemala.

Boy

Bruce

Delgado

2002

Environ Health Perspect

262

179

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In this study, we aimed to establish whether domestic use of wood fuel is associated with reduced birth weight, independent of key maternal, social, and economic confounding factors. We studied 1,717 women and newborn children in rural and urban communities in rural Guatemala. We identified subjects through home births reported by traditional birth attendants in six rural districts (n = 572) and all public hospital births in Quetzaltenango city during the study period (n = 1,145). All were seen within 72 hr of delivery, and data were collected on the type of household fuel used, fire type, and socioeconomic and other confounding factors. Smoking among women in the study community was negligible. Children born to mothers habitually cooking on open fires (n = 861) had the lowest mean birth weight of 2,819 g [95% confidence interval (CI), 2,790-2,848]; those using a chimney stove (n = 490) had an intermediate mean of 2,863 g (95% CI, 2,824-2,902); and those using the cleanest fuels (electricity or gas, n = 365) had the highest mean of 2,948 g (95% CI, 2,898-2,998) (p< 0.0001). The percentage of low birth weights (< 500 g) in these three groups was 19.9% (open fire), 16.8% (chimney stove), and 16.0% (electricity/gas), (trend (p = 0.08). Confounding factors were strongly associated with fuel type, but after adjustment wood users still had a birth weight 63 g lower (p = 0.05; 95% CI, 0.4-126). This is the first report of an association between biofuel use and reduced birth weight in a human population. Although there is potential for residual confounding despite adjustment, the better-documented evidence on passive smoking and a feasible mechanism through carbon monoxide exposure suggest this association may be real. Because two-thirds of households in developing countries still rely on biofuels and women of childbearing age perform most cooking tasks, the attributable risk arising from this association, if confirmed, could be substantial.

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“…The influence of smoking on fertility, pregnancy and lactation Paulo Roberto Bezerra de Mello 1 , Gilberto Rodrigues Pinto 2 , Clovis Botelho 3 A fumaça do cigarro no ambiente é derivada de duas origens: fumaça central (FC) e fumaça periférica (FP). A fumaça central é formada quando o fumante traga o cigarro, é produzida com altas temperaturas, acima de 950ºC, e polui o ambiente após ter sido puxada através do cigarro, filtrada pelos pulmões do fumante e em seguida exalada 1-3. Essa é a fonte predominante de exposição dos fumantes ativos.…”

Section: Influência Do Tabagismo Na Fertilidade Gestação E Lactaçãounclassified

Influência do tabagismo na fertilidade, gestação e lactação

Mello¹,

Pinto²,

Botelho³

2001

J. Pediatr. (Rio J.)

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Objective: to decribe the influence of smoking on different phases of the reproductive process, fecundation, pregnancy and lactation, drawing special attention to the mechanisms of action of the main toxic components found in cigarettes. To suggest prophylactic measures for environmental control and how to reduce children's exposure to tobacco smoke.Methods: nonsystematic literature review using MEDLINE database.Results: smoking has a negative effect on different phases of the reproduction process, by direct action of main toxic components, nicotine and carbon monoxide. Smoking reduces fertility, compromises the length of gestation and infant birthweight. Smoking mothers also have reduced breast milk production and shorter lactation, which affects infant weight gain through unclear mechanisms in which prolactin may probably be involved.Conclusions: smoking compromises reproductive function quality in different phases, acting mainly on intrauterine and extrauterine development of infants. Since during pregnancy and lactation women are in closer contact with health professionals, antismoking campaigns should be especially addressed to this period.J Pediatr (Rio J) 2001; 77 (4): 257-64: smoking, fertility, pregnancy, lactation, breast feeding. ResumoObjetivo: descrever a influência do tabagismo nas diferentes fases do processo reprodutivo, fecundação, gestação e lactação, destacando os mecanismos de ação dos principais componentes tóxicos do cigarro nestas fases. Sugerir medidas profiláticas de controle ambiental e de como reduzir a exposição da criança à fumaça do tabaco.Métodos: revisão bibliográfica não sistemática sobre os temas abordados, utilizando-se da base de dados do MEDLINE.Resultados: o tabagismo atua negativamente nas diferentes fases da reprodução, por ação direta de seus principais componentes tóxicos, a nicotina e o monóxido de carbono. Reduz a taxa de fertilidade, compromete a duração da gestação e o peso do concepto. Também diminui a produção de leite da nutriz fumante e o tempo de lactação, comprometendo o ganho de peso da prole, por mecanismos ainda não bem compreendidos, nos quais a prolactina pode estar envolvida.Conclusões: os efeitos do tabagismo comprometem a qualidade da função reprodutiva em diferentes fases, por atuar principalmente sobre o desenvolvimento do concepto, tanto na fase intra quanto na fase extra-uterino. Por ser um período de contato mais freqüente da mulher fumante com o profissional de saúde, a gestação e a lactação deveriam ser alvo especial de campanhas antitabágicas.J Pediatr (Rio J) 2001; 77 (4): 257-64: tabagismo, fertilidade, gestação, lactação, aleitamento materno. Influência do tabagismo na fertilidade, gestação e lactaçãoThe influence of smoking on fertility, pregnancy and lactation Paulo Roberto Bezerra de Mello 1 , Gilberto Rodrigues Pinto 2 , Clovis Botelho 3A fumaça do cigarro no ambiente é derivada de duas origens: fumaça central (FC) e fumaça periférica (FP). A fumaça central é formada quando o fumante traga o cigarro, é produzida com altas temperat...

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Importance of exposure to gaseous and particulate phase components of tobacco smoke in active and passive smokers

Cited by 60 publications

References 29 publications

Obstetric and perinatal effects of active and/or passive smoking during pregnancy

Obstetric and perinatal effects of active and/or passive smoking during pregnancy

Birth weight and exposure to kitchen wood smoke during pregnancy in rural Guatemala.

Influência do tabagismo na fertilidade, gestação e lactação

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