Prevalence of pre-gestational and gestational smoking and factors associated with smoking cessation during pregnancy, Brazil, 2011-2012

Abstract

Gestational smoking is associated with various adverse maternal and fetal outcomes. Over the last three decades, despite considerable advances in tobacco control policy in Brazil, gestational smoking has caused a considerable number of fetal deaths and disabilities. The aim of this study is to estimate the prevalence of pre-gestational and gestational smoking and to identify the factors associated with smoking cessation up to the 20 th gestational week. Methods: “Birth in Brazil” was a nationwide hospital-based study conducted from February 2011 to October 2012. Smoking prevalence and smoking cessation during pregnancy was estimated through face-to-face interviews with postpartum women during hospitalization for birth care. We performed multivariate logistic regression to verify the factors associated with smoking cessation up to the 5th month of pregnancy. Results: prevalence of pre-gestational smoking of 16.1% (CI 95% 15.3%-16.9%); prevalence of smoking any time during pregnancy of 9.6% (CI 95% 9.0%-10.3%); and prevalence of smoking cessation up to the 5th month of pregnancy of 56.7% (CI 95% 54.0%-59.4%). The factors associated with smoking cessation were residence in the North, Northeast, and Central-West of Brazil, having received at least one prenatal consultation (OR 3.51 CI 95% 1.85–6.67), more years of schooling (15 or more vs less than 7 years of schooling OR 5.54 CI 95% 2.97–10.34), living with a partner (OR 1.35 CI 95% 1.01–1.79), no children prior to the index pregnancy (OR 2.77 CI 95% 2.13–3.61), and absence of alcohol use (1.74 CI 95% 1.39–2.18) or of suspected alcohol abuse (OR 1.62 CI 95% 1.07–2.45). Conclusion: The estimated smoking rate during pregnancy in Brazil is still high and is associated with factors of increased maternal social vulnerability, which may contribute to the increased occurrence of unfavorable perinatal outcomes.

Individual and contextual variables associated with smoking and alcohol consumption during pregnancy

“…The prevalence found in the present study for smoking was slightly higher than the national average estimated (21) , but similar to another study with data from all over the country (24) , which found 9.6% of pregnant women smoking at some point during pregnancy. Regarding the prevalence found for alcohol consumption, specific studies in different regions of the country, such as Rio Grande do Sul and Rio de Janeiro (25)(26) , found similar results to the present research.…”

Neonatal near miss and the occurrence of negative outcomes in the first year of life: data from a national survey, Nascer no Brasil (Born in Brazil), 2011-2012

“…Self-reported maternal information, such as maternal smoking, may be underestimated due to pregnant women's knowledge of harmful effects to mother and child's health. 29 The fact that the condition of an ex-smoker was not considered as a distinct category of maternal smoking, it may have weakened the magnitude of the associations. In addition to self-report on alcohol consumption was measured using TWEAK.…”

Protective factors against tobacco and alcohol use among pregnant women from a tribal nation in the Central United States

“…In addition to the mother's education and depression classification, the current study looks at other factors which have been studied in relation to prenatal substance use: maternal living arrangement (alone or with someone) [21,23], yearly income [22], and PTSD classification [24]. It also investigates if the education or employment of the father and mother together would alter maternal smoking rates.…”

“…Risk factors for alcohol use include depression [21,22], anxiety [21], being unmarried [22], belonging to a lower socioeconomic status [22], and being black [22] or white [20]. Protective factors against smoking during pregnancy include attending one prenatal consult [23], more years of schooling [23], living with a partner [21,23], having no previous children [23], and the absence of alcohol use [23]. Having PTSD [24] or depression [21,25] increases the risk of both alcohol and tobacco use during pregnancy.…”