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Sigvardsson I, Ludvigsson J, Andersson B, Størdal K, Mårild K. Tobacco Smoke Exposure in Early Childhood and Later Risk of Inflammatory Bowel Disease: A Scandinavian Birth Cohort Study. J Crohns Colitis 2024; 18:661-670. [PMID: 38329478 PMCID: PMC11140631 DOI: 10.1093/ecco-jcc/jjae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVES To examine the association between early-life smoking exposure and later risk of inflammatory bowel disease [IBD]. METHODS We followed 115663 participants from the Norwegian Mother, Father and Child [MoBa] and All Babies in Southeast Sweden [ABIS] cohorts from birth [1997-2009] through 2021. IBD was identified through national patient registers. Validated questionnaire data defined maternal smoking during pregnancy, maternal environmental tobacco smoke [ETS] exposure during pregnancy, and child ETS exposure by ages 12 and 36 months. Cox regression was used to estimate adjusted hazard ratios [aHRs] for sex, maternal age, education level, parental IBD, and origin. Cohort-specific estimates were pooled using a random-effects model. RESULTS During 1 987 430 person-years of follow-up, 444 participants developed IBD [ABIS, 112; MoBa, 332]. Any vs no maternal smoking during pregnancy yielded a pooled aHR of 1.30 [95% CI = 0.97-1.74] for offspring IBD. Higher level of maternal smoking during pregnancy (compared with no smoking, average ≥6 cigarettes/day: pooled aHR = 1.60 [95% CI = 1.08-2.38]) was associated with offspring IBD, whereas a lower smoking level was not (average 1-5 cigarettes/day: pooled aHR = 1.09 [95% CI = 0.73-1.64]). Child ETS exposure in the first year of life was associated with later IBD (any vs no ETS, pooled aHR = 1.32 [95% CI = 1.03-1.69]). Estimates observed for child ETS exposure by 36 months were similar but not statistically significant. CONCLUSIONS In this prospective Scandinavian cohort study, children exposed to higher levels of maternal smoking during pregnancy or ETS during the first year of life were at increased risk of later IBD.
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Affiliation(s)
- Ida Sigvardsson
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
| | - Johnny Ludvigsson
- Crown Princess Victoria Children’s Hospital, Region Östergötland, Linköping, Sweden
- Division of Pediatrics, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Björn Andersson
- Bioinformatics and Data Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ketil Størdal
- Department of Pediatric Research, Faculty of Medicine, University of Oslo, Oslo, Norway
- Children’s Center, Oslo University Hospital, Oslo, Norway
| | - Karl Mårild
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
- Department of Pediatrics, Queen Silvia Children’s Hospital, Gothenburg, Sweden
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Li L, Wang J, Xia W, Li WHC, Weng X, Song P. Smoking cessation and relapse-prevention interventions tailored for expectant and new fathers: protocol of a systematic review and network meta-analysis. BMJ Open 2023; 13:e071745. [PMID: 37802607 PMCID: PMC10565286 DOI: 10.1136/bmjopen-2023-071745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION Exposure of pregnant women and newborns to secondhand smoke (SHS) can lead to adverse maternal and neonatal health outcomes. Among expectant and new fathers, who are the main source of SHS exposure for pregnant women, new mothers and babies, smoking rates remain high. A partner's pregnancy potentially constitutes a critical period where expectant and new fathers are motivated to quit smoking. However, there is no consensus on the optimal form and delivery of smoking cessation and relapse-prevention interventions. We present a systematic review and network meta-analysis protocol that aims to synthesise and evaluate the effectiveness of smoking cessation and relapse-prevention interventions tailored for this population. METHODS AND ANALYSIS To identify relevant studies, we will conduct a comprehensive search, in English and Chinese, of 10 electronic databases. The review will include randomised and quasi-randomised controlled trials that compare behavioural interventions (tailored and non-tailored) with/without the addition of pharmacotherapy with usual care, a minimal or placebo control for assisting expectant and new fathers to quit smoking and prevent smoking relapse. The primary outcome of interest is the self-reported and/or biochemically verified smoking abstinence at ≥1-month follow-up. Two reviewers will independently screen, select and extract relevant studies, and perform a quality assessment. Disagreements will be resolved by a consensus or third-party adjudication. The Cochrane Risk of Bias tool V.2 will be used to assess the risk of bias in the included studies. We will obtain the results of the systematic review through pooled quantitative analyses using a network meta-analysis. Sensitivity and subgroup analyses will be performed. ETHICS AND DISSEMINATION Ethical approval is not required for this systematic review of published data. The findings will be disseminated via peer-reviewed publication. PROSPERO REGISTRATION NUMBER CRD42022340617.
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Affiliation(s)
- Lishan Li
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jiani Wang
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wei Xia
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - William H C Li
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Xueling Weng
- Department of Gynecology and Obstetrics, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Peige Song
- School of Public Health, Zhejiang University, Hangzhou, China
- Centre for Global Health Research, The University of Edinburgh, Edinburgh, UK
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Corrêa PCRP, de Sales RKB, Knorst MM, Pinto SRHL, Ragnini LFQ, Tourinho CAP, Storrer KM, Scuarcialupi MECDA, Castellano MVCDO, Albuquerque AAD, Ravara SB. The challenge of tobacco and nicotine use among women. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e2023S124. [PMID: 37556643 PMCID: PMC10411695 DOI: 10.1590/1806-9282.2023s124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Paulo César Rodrigues P. Corrêa
- Universidade Federal de Ouro Preto, Faculdade de Medicina – Ouro Preto (MG), Brazil
- Brazilian Thoracic Society, Tobacco Control Section – Brasília (DF), Brazil
| | - Roberta Karla B. de Sales
- Universidade de São Paulo, Faculdade de Medicinaa, Hospital das Clínicas, Instituto do Coração, Departamento de Pneumologia – São Paulo (SP), Brazil
| | - Marli Maria Knorst
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Pneumológicas, Faculdade de Medicina – Porto Alegre (RS), Brazil
| | | | | | | | | | | | - Maria Vera C. De O. Castellano
- Hospital do Servidor Público Estadual de São Paulo (Hospital do Servidor Público Estadual – Instituto de Assistência Médica ao Servidor Público Estadual) – São Paulo (SP), Brazil
| | | | - Sofia Belo Ravara
- Universidade da Beira Interior, Centro de Investigação em Ciências da Saúde – Covilhã, Portugal
- Centro Hospitalar Universitário da Cova da Beira – Covilhã, Portugal
- Universidade NOVA, Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública (CISP) – Lisboa, Portugal
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Lin Y, Craig E, Liu X, Ge Y, Brunner J, Wang X, Yang Z, Hopke PK, Miller RK, Barrett ES, Thurston SW, Murphy SK, O'Connor TG, Rich DQ, Zhang JJ. Urinary 1-hydroxypyrene in pregnant women in a Northeastern U.S. city: socioeconomic disparity and contributions from air pollution sources. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023:10.1038/s41370-023-00555-9. [PMID: 37161057 DOI: 10.1038/s41370-023-00555-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Maternal exposure to polycyclic aromatic hydrocarbons (PAHs), ubiquitous constituents of air pollution, has been associated with adverse birth outcomes. Yet it remains unclear whether and how socioeconomic status (SES) affects gestational PAH exposure. OBJECTIVE To examine whether there are socioeconomic disparities in PAHs exposure among pregnant women from Rochester, NY, and if so, to what extent disproportionate proximity to air pollution sources, measured by residential distance to transportation-related sources, contributed to the exposure disparity. METHODS We measured 1-hydroxypyrene concentrations in 726 urine samples collected from 305 pregnant women up to three samples throughout pregnancy. Residential distances to transportation-related sources were calculated based on participants' home addresses. We used linear mixed-effects models with random intercepts of participants to examine associations between 1-hydroxypyrene, SES indicators, and distance to transportation-related sources. We used structural equation modelling to assess to what extent distance to transportation-related sources contributes to the socioeconomic disparity in 1-hydroxypyrene concentrations. RESULTS Reduced household income and maternal education level were both significant SES predictors of 1-hydroxypyrene concentrations, after the adjustment for other maternal demographic characteristics. Each interquartile range (IQR) increases in residential proximity to the airport (from 14.3 to 6.0 km), the railroad yard (from 22.3 to 6.0 km), and annual average daily traffic within 300 m (from 3796 to 99,933 vehicles/year) were associated with 15.0% (95%CI: 7.0-22.2%), 15.4% (95%CI: 6.5-23.5%), and 13.6% (95%CI: 4.7-23.3%) increases in 1-hydroxypyrene concentrations, respectively. Proximity to these sources jointly explained 10% (95%CI: 1.6-18.4%) of the 1-hydroxypyrene concentration change associated with decreases in SES as a latent variable defined by both household income and education level. IMPACT STATEMENT Our findings suggest that efforts to address disproportionate residential proximity to transportation-related sources may reduce the socioeconomic disparity in PAH exposure.
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Affiliation(s)
- Yan Lin
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Emily Craig
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Xiaodong Liu
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Health, National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yihui Ge
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Jessica Brunner
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Xiangtian Wang
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Zhenchun Yang
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Philip K Hopke
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Institute for a Sustainable Environment, Clarkson University, Potsdam, NY, USA
| | - Richard K Miller
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
- Department of Pathology and Clinical Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Emily S Barrett
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Department of Epidemiology and Biostatistics, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Sally W Thurston
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Thomas G O'Connor
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA
| | - David Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Junfeng Jim Zhang
- Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, NC, USA.
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Murakami K, Obara T, Ishikuro M, Ueno F, Noda A, Kuriyama S. Associations of Education and Income with Secondhand Smoke Exposure Among Non-smoking Pregnant Women in Japan: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Matern Child Health J 2023:10.1007/s10995-023-03648-x. [PMID: 36988795 DOI: 10.1007/s10995-023-03648-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES There is accumulating evidence that lower socioeconomic groups are more exposed to secondhand smoke (SHS) than higher ones in the general population. The objective of the study was to examine the associations of education and income with SHS exposure among non-smoking pregnant women in Japan. METHODS We analyzed data from 11,615 non-smoking pregnant women in Japan who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017. SHS exposure was defined as indoor exposure to someone else's cigarette smoke ≥ 1 day/week during pregnancy. Multiple logistic regression analyses were conducted to examine whether pregnant women's educational attainment or equivalent household income was associated with SHS exposure, adjusting for covariates. Stratified analyses by work status were also conducted. RESULTS The prevalence of SHS exposure during pregnancy was 32.6%; 27.6% among non-working women and 35.8% among working women. Lower educational attainment was associated with an increased risk of SHS exposure; the odds ratio of high school education or lower compared with university education or higher was 1.87 (95% confidence interval, 1.66-2.10). Lower equivalent household income was associated with an increased risk of SHS exposure; the odds ratio of the lowest compared with the highest level of income was 1.53 (95% confidence interval, 1.35-1.74). These associations did not differ between non-working women and working women. CONCLUSIONS FOR PRACTICE Associations of education and income with SHS exposure imply that educational interventions and financial incentives are needed for pregnant women and their household smokers.
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Affiliation(s)
- Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan.
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan.
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
| | - Fumihiko Ueno
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan
- Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8573, Japan
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Hamadneh J, Hamadneh S. The impact of an online educational program to reduce second-hand exposure to smoke among nonsmoking pregnant women; a hospital-based intervention study. Heliyon 2023; 9:e13148. [PMID: 37089336 PMCID: PMC10119503 DOI: 10.1016/j.heliyon.2023.e13148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 01/04/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Background Second-hand smoke is recognized as a public health concern, especially for pregnant women. Objectives To compare pregnant women's exposure and perceptions of SHS pre-and post-intervention. Materials and methods The study was conducted with a sample of 32 pregnant women at a tertiary university hospital in Jordan. Using a semi-structured questionnaire, researchers asked women about their knowledge, attitude and behavior regarding prenatal exposure to smoke before and after an intervention that included motivation, communication, education and counselling by using a range of media. A cotinine test was conducted to measure levels in second-hand smokers. Results The average maternal age was 30.88 ± 1.69 years; 68% were highly educated, 43% were employed, 37% reported not having sufficient income, and 62% did not attend for antenatal care on a regular basis. There was a significant increase in knowledge and awareness regarding second-hand smoking and its effect on pregnancy outcomes after the intervention. More than 90% of pregnant women supported a comprehensive policy in relation to smoking, and 33% of used to leave the room where others smoked. This percentage increased to 70% after the intervention. Cotinine level decreased after the intervention in 81% of cases. Conclusions There is an increase in knowledge and awareness regarding second-hand smoking and its effects on pregnancy outcomes after implementation of an educational intervention.
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Wheeler DC, Boyle J, Jeremy Barsell D, Maguire RL, Zhang J(J, Oliver JA, Jones S, Dahman B, Murphy SK, Hoyo C, Baggett CD, McClernon J, Fuemmeler BF. Tobacco Retail Outlets, Neighborhood Deprivation and the Risk of Prenatal Smoke Exposure. Nicotine Tob Res 2022; 24:2003-2010. [PMID: 35793204 PMCID: PMC9653076 DOI: 10.1093/ntr/ntac164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/09/2022] [Accepted: 07/05/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Smoking and smoke exposure among pregnant women remain persistent public health issues. Recent estimates suggest that approximately one out of four nonsmokers have measurable levels of cotinine, a marker indicating regular exposure to secondhand smoke. Epidemiological research has attempted to pinpoint individual-level and neighborhood-level factors for smoking during pregnancy. However, most of these studies have relied upon self-reported measures of smoking. AIMS AND METHODS To more accurately assess smoke exposure resulting from both smoking and secondhand exposure in mothers during pregnancy, we used Bayesian regression models to estimate the association of cotinine levels with tobacco retail outlet (TRO) exposure and a neighborhood deprivation index (NDI) in six counties in North Carolina centered on Durham County. RESULTS Results showed a significant positive association between TRO exposure (β = 0.008, 95% credible interval (CI) = [0.003, 0.013]) and log cotinine after adjusting for individual covariates (eg, age, race/ethnicity, education, marital status). TRO exposure was not significant after including the NDI, which was significantly associated with log cotinine (β = 0.143, 95% CI = [0.030, 0.267]). However, in a low cotinine stratum (indicating secondhand smoke exposure), TRO exposure was significantly associated with log cotinine (β = 0.005, 95% CI = [0.001, 0.009]), while in a high cotinine stratum (indicating active smoking), the NDI was significantly associated with log cotinine (β = 0.176, 95% CI = [0.005, 0.372]). CONCLUSIONS In summary, our findings add to the evidence that contextual factors are important for active smoking during pregnancy. IMPLICATIONS In this study, we found several significant associations that suggest a more nuanced understanding of the potential influence of environmental- and individual-level factors for levels of prenatal smoke exposure. Results suggested a significant positive association between TRO exposure and cotinine levels, after adjusting for the individual factors such as race, education, and marital status. Individually, NDI was similarly positively associated with cotinine levels as well. However, when combining TRO exposure alongside NDI in the same model, TROs were no longer significantly associated with overall cotinine levels.
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Affiliation(s)
- David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Joseph Boyle
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - D Jeremy Barsell
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Rachel L Maguire
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27701, USA
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27695, USA
| | - Junfeng (Jim) Zhang
- Environmental Science and Policy Division, Duke Global Health Institute and Nicholas School of the Environment, Durham, NC 27708, USA
| | - Jason A Oliver
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27701, USA
| | - Shaun Jones
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27701, USA
| | - Bassam Dahman
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27701, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27695, USA
| | - Chris D Baggett
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27701, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA 23298, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298, USA
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Artzi-Medvedik R, Mohamed N, Chertok IRA. Pregnant Women's Perception of Secondhand Smoke Exposure. MCN Am J Matern Child Nurs 2022; 47:353-358. [PMID: 36227075 DOI: 10.1097/nmc.0000000000000863] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Birth outcomes including low birth weight, preterm birth, and delayed infant neurodevelopment are associated with secondhand smoke exposure while pregnant. The purpose of the study was to explore pregnant women's perspectives on secondhand smoke exposure to understand their experience and inform recommendations. STUDY DESIGN AND METHODS Qualitative semistructured interviews were conducted with 15 secondhand smoke-exposed pregnant women in the United States. RESULTS Four primary themes were identified: feeling powerless, trapped, and discomfort; enhancing women's self-advocacy and initiative; having conflicting feelings about secondhand smoke exposure; and desiring professional advice and education. Women expressed concern about prenatal secondhand smoke exposure, although they felt unable to request that people refrain from smoking in their presence or personal space. Women's strategies to minimize secondhand smoke exposure often involved their own social isolation. Women described sources of support, educational needs, and desire for practical advice in secondhand smoke avoidance. CLINICAL IMPLICATIONS Findings underscore the role of nurses working with pregnant women living with household members who smoke to educate women about secondhand smoke risks and strategies for avoidance and to enhance women's self-confidence in advocating for themselves to reduce their exposure.
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Taha MN, Al-Ghumgham Z, Ali N, Al-Rifai RH, Elbarazi I, Al-Maskari F, El-Shahawy O, Ahmed LA, Loney T. Tobacco Use and Exposure to Environmental Tobacco Smoke amongst Pregnant Women in the United Arab Emirates: The Mutaba'ah Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127498. [PMID: 35742747 PMCID: PMC9224424 DOI: 10.3390/ijerph19127498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/10/2022]
Abstract
Self-reported tobacco use is high in the male adult Emirati population (males ~36% vs. females ~3%); however, there are minimal data on tobacco use or exposure to environmental tobacco smoke (ETS) during pregnancy in the United Arab Emirates (UAE). This study investigated the prevalence of, and factors associated with, tobacco use and exposure to environmental tobacco smoke (ETS) amongst pregnant women in the UAE. Baseline cross-sectional data were analysed from the Mutaba’ah Study. Expectant mothers completed a self-administered questionnaire collecting sociodemographic information, maternal tobacco use, and ETS exposure during antenatal visits at three hospitals in Al Ain (UAE; May 2017–February 2021). Amongst 8586 women included in the study, self-reported tobacco use during pregnancy was low (0.7%), paternal tobacco use was high (37.9%), and a third (34.8%) of expectant mothers were exposed to ETS (28.0% at home only). Pregnant women who were employed (adjusted odds ratio (aOR): 1.35, 95% confidence interval (CI): 1.19–1.52), with childbirth anxiety (aOR 1.21, 95% CI 1.08–1.36), and with an increased number of adults living in the same household (aOR 1.02 95% CI 1.01–1.03) were independently more likely to be exposed to ETS. Pregnant women with higher education levels (aOR 0.84, 95% CI 0.75–0.94) and higher gravidity (aOR 0.95, 95% CI 0.92–0.99) were less likely to be exposed to ETS. Public health efforts targeting smoking cessation amongst husbands and promoting smoke-free homes are warranted to help reduce prenatal ETS exposure in the UAE.
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Affiliation(s)
- Mohammed Nagdi Taha
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates; (M.N.T.); (Z.A.-G.)
| | - Zaki Al-Ghumgham
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates; (M.N.T.); (Z.A.-G.)
| | - Nasloon Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates
| | - Omar El-Shahawy
- Tobacco, Alcohol and Drug Use Section, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA;
- Division of Global Health, New York University School of Global Public Health, New York, NY 10003, USA
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates; (M.N.T.); (Z.A.-G.)
- Correspondence: ; Tel.: +971-43-838-737
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10
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Mu D, Li H, Wang D, Yang X, Wang S. Analysis of Environmental and Social Significant Factors Affecting the Flow of Maternal Patients in Jilin, China. Front Public Health 2022; 10:780452. [PMID: 35669749 PMCID: PMC9164295 DOI: 10.3389/fpubh.2022.780452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background With the implementation of China's Two-child policy, the number of pregnant women has been increasing year by year in recent years. However, the pregnancy success rate of pregnant women is declining year by year, and it is almost necessary for all the elderly mothers to do pregnancy protection. Objective The purpose of this study is to analyze the social and environmental factors that affect the patient flow of pregnant women in Jilin area of China, and further utilize the favorable factors to avoid the negative effects of adverse factors, so as to improve the pregnancy success rate and eugenics level. Methods Monthly patient flow data from 2018 to 2020 were collected in the obstetrics department of the First Hospital of Jilin University. The decompose function in R software was used to decompose the time series data, and the seasonal and trend change rules of the data were obtained; the significant factors influencing patient flow were analyzed by using Poisson regression model, and the prediction model was verified by using assumptions, such as the normal distribution of residuals and the constant difference of residuals. Results Temperature in environmental factors (P = 4.00E−08) had a significant impact on the flow of obstetric patient. The flow of patients was also significantly affected by the busy farming (P = 0.0013), entrance (P = 3.51E−10) and festivals (P = 0.00299). The patient flow was accompanied by random flow, but also showed trend change and seasonal change. The trend of change has been increasing year by year. The seasonal variation rule is that the flow of patients presents a trough in February every year, and reaches the peak in July. Conclusion In this article, Poisson regression model is used to obtain the social and environmental significant factors of obstetric patient flow. According to the significant factors, we should give full play to significant factors to further improve the level of eugenics. By using time series decomposition model, we can obtain the rising trend and seasonal trend of patient flow, and then provide the management with decision support, which is conducive to providing pregnant women with higher level of medical services and more comfortable medical experience.
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Affiliation(s)
- Dongmei Mu
- Department of Clinical Research, The First Hospital of Jilin University, Changchun, China.,School of Public Health, Jilin University, Changchun, China
| | - Hua Li
- Department of Abdominal Ultrasound, The First Hospital of Jilin University, Changchun, China.,School of Public Health, Jilin University, Changchun, China
| | - Dongxuan Wang
- Department of Abdominal Ultrasound, The First Hospital of Jilin University, Changchun, China
| | - Xinyu Yang
- School of Public Health, Jilin University, Changchun, China
| | - Shutong Wang
- School of Public Health, Jilin University, Changchun, China
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11
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Miller CA, Jung Kim S, Schwartz-Bloom RD, Bloom PN, Murphy SK, Fuemmeler BF. Informing women about the risks of exposing babies to tobacco smoke: outreach and education efforts using Facebook "boost posts". Transl Behav Med 2022; 12:714-720. [PMID: 35532323 PMCID: PMC9154290 DOI: 10.1093/tbm/ibab158] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Maternal smoking is associated with a host of negative health outcomes, including an increased risk of children developing attention-deficit/hyperactivity disorder (ADHD). This study evaluated the efficacy of health messages disseminated through Facebook Ads focused on reducing tobacco smoke exposure during pregnancy. Two message versions were promoted via post advertisements on Facebook-a static infographic and a video containing an animated version of the infographic. The reach of and engagement with each message version was evaluated. Comments made to the posts were assessed using content analysis. The infographic reached approximately 60,000 people and the video reached about 16,000 people. The average costs were $10.00 and $40.00 per 1,000 people reached for the infographic- and video-based posts, respectively. While there was no engagement with the video, the infographic was liked (n = 157), given alternative likes (n = 59), shared (n = 171 to 341), and commented on (n = 221). About one-quarter of comments contained a personal narrative and mentions of health history related to ADHD and/or smoking. Comments were more often negative (than positive) (16.6% vs 3.9%) and expressed skepticism more often than message acceptance (21.5% vs 12.2%). Facebook users were more responsive to the infographic (compared to the video) and static posts were a preferred channel (i.e., higher engagement at a lower cost) to disseminate messages when using the boost post feature on Facebook for health education. Our review of the comments provided insights into message acceptance and guidance for future social media-based health message campaigns. However, it is not known whether and if so, how, these findings on message exposure would correlate with behavioral intentions or changes in behavior, such as intentions to quit smoking or smoking cessation.
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Affiliation(s)
- Carrie A Miller
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23219, USA
| | - Sunny Jung Kim
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23219, USA
| | | | - Paul N Bloom
- Duke Innovation & Entrepreneurship Initiative, Durham, NC 27701, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27701, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23219, USA
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12
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Wheeler DC, Boyle J, Barsell DJ, Maguire RL, Dahman B, Murphy SK, Hoyo C, Zhang J, Oliver JA, McClernon J, Fuemmeler BF. Neighborhood Deprivation is Associated with Increased Risk of Prenatal Smoke Exposure. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1078-1089. [PMID: 35179695 DOI: 10.1007/s11121-022-01355-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 02/01/2023]
Abstract
Despite years of advisories against the behavior, smoking among pregnant women remains a persistent public health issue in the USA. Recent estimates suggest that 9.4% of women smoke before pregnancy and 7.1% during pregnancy in the USA. Epidemiological research has attempted to pinpoint individual-level and neighborhood-level factors for smoking during pregnancy, including educational attainment, employment status, housing conditions, poverty, and racial demographics. However, most of these studies have relied upon self-reported measures of smoking, which are subject to reporting bias. To more accurately and objectively assess smoke exposure in mothers during pregnancy, we used Bayesian index models to estimate a neighborhood deprivation index (NDI) for block groups in Durham County, North Carolina, and its association with cotinine, a marker of smoke exposure, in pregnant mothers (n = 887 enrolled 2005-2011). Results showed a significant positive association between NDI and log cotinine (beta = 0.20, 95% credible interval = [0.11, 0.29]) after adjusting for individual covariates (e.g., race/ethnicity and education). The two most important variables in the NDI according to the estimated index weights were percent females without a high school degree and percent Black population. At the individual level, Hispanic and other race/ethnicity were associated with lowered cotinine compared with non-Hispanic Whites. Higher education levels were also associated with lowered cotinine. In summary, our findings provide stronger evidence that the socio-geographic variables of educational attainment and neighborhood racial composition are important factors for smoking and secondhand smoke exposure during pregnancy and can be used to target intervention efforts.
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Affiliation(s)
- David C Wheeler
- Department of Biostatistics, One Capitol Square, Virginia Commonwealth University, 7th Floor, 830 East Main St, Richmond, VA, 23298, USA.
| | - Joseph Boyle
- Department of Biostatistics, One Capitol Square, Virginia Commonwealth University, 7th Floor, 830 East Main St, Richmond, VA, 23298, USA
| | - D Jeremy Barsell
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, 23298-0032, USA
| | - Rachel L Maguire
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, 27710, USA.,Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, 27695, USA
| | - Bassam Dahman
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, 23298-0032, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, 27695, USA
| | - Jim Zhang
- Duke Global Health Institute, Durham, NC, 27708, USA
| | - Jason A Oliver
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27701, USA.,TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, 73104, USA.,Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, 74136, USA
| | - Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27701, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, 23298-0032, USA.,Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, 23298, USA
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13
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Sanjeevi N, Sachdev PK. Household food insecurity and in-utero and early life smoke exposure: Data from NHANES 2003-2016. Prev Med 2021; 150:106710. [PMID: 34181942 DOI: 10.1016/j.ypmed.2021.106710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/18/2021] [Accepted: 06/23/2021] [Indexed: 10/21/2022]
Abstract
In-utero, postnatal, and childhood smoke exposure are associated with adverse health consequences, and examining factors related to smoke exposure during these vulnerable periods are critical to inform efforts that promote maternal and child health. This study included pregnant and postpartum women aged 20-44 years and children aged 3-12 years from National Health and Nutrition and Examination Survey (NHANES) 2003-2016 cycles. Logistic regression examined association of household food insecurity with firsthand (FHS) and secondhand (SHS) exposure among pregnant and postpartum women, and SHS exposure among children, based on serum cotinine and respondent-reports. Very low household food security was significantly associated with increased odds of cotinine-based FHS exposure among pregnant (OR(95%CI) = 5.19 (1.75, 15.39)) and postpartum women (OR(95%CI) = 4.75(1.66, 13.57)). Non-smoking, postpartum women from very low food secure households also had significantly greater odds of cotinine-based SHS exposure (OR(95%CI) = 7.40 (2.08, 26.37)) than those from food secure households. Using respondent-reported smoking status, low food security in pregnant and postpartum women was significantly related to increased odds of FHS exposure (OR(95% CI) = 3.75(1.52, 9.23)). Further, children from marginal, low and very low food secure households had significantly higher odds of SHS exposure compared to those from food secure households. Results imply the co-occurrence food insecurity and in-utero and early life smoke exposure.
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Affiliation(s)
- Namrata Sanjeevi
- The University of Texas at Austin, Department of Nutritional Sciences, College of Natural Sciences, United States.
| | - Prageet K Sachdev
- The University of Texas at Austin, Department of Nutritional Sciences, College of Natural Sciences, United States
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14
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Dobbs PD, Branscum P, Cohn AM, Tackett AP, Comiford AL. Pregnant Smokers' Intention to Switch From Cigarettes to E-Cigarettes: A Reasoned Action Approach. Womens Health Issues 2021; 31:540-549. [PMID: 34452825 DOI: 10.1016/j.whi.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This study used the reasoned action approach (RAA) to examine 1) factors associated with pregnant smokers' intention to switch from cigarettes to e-cigarettes and 2) the influence that intention to switch had on future expectations to resume cigarette use postpartum. METHODS U.S. pregnant women (N = 267) who reported past 30-day use of cigarettes completed an online cross-sectional survey between November and December 2019. A 30-item scale measured RAA constructs (intention, instrumental attitudes, experiential attitudes, injunctive norms, descriptive norms, perceived autonomy, and perceived capacity). A confirmatory factor analysis confirmed and structural equation modeling tested the RAA constructs' association with intention to switch and the relationship between intention to switch and future expectations to resume smoking after pregnancy. RESULTS The confirmatory factor analysis confirmed the seven-factor measurement model. Structural equation modeling found instrumental attitudes (β = 0.43; p < .001) and descriptive norms (β = 0.53; p < .001) were associated with intention to switch from cigarettes to e-cigarettes. However, there were differences between the constructs' relationships with intention between those who did and did not use e-cigarettes in the past 30 days. Intention to switch was inversely related with future expectations to resume smoking postpartum (β = -0.13; p < .001). CONCLUSIONS This study examined multiple facets of behavioral decision-making that may influence pregnant smokers' intention to switch to e-cigarettes during pregnancy. In this sample, pregnant people who believed switching from cigarettes to e-cigarettes was important and that other smokers commonly switched during pregnancy reported greater intention to switch. Novel theories, such as the RAA, may provide an optimal lens to understand pregnant smokers' behavioral decision-making process as they consider switching from cigarettes to e-cigarettes.
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Affiliation(s)
- Page D Dobbs
- Health, Human Performance and Recreation Department, University of Arkansas, Fayetteville, Arkansas; Health and Exercise Science Department, University of Oklahoma, Norman, Oklahoma.
| | - Paul Branscum
- Department of Kinesiology and Health, Miami University, Oxford, Ohio
| | - Amy M Cohn
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Alayna P Tackett
- Keck School of Medicine, University of Southern California, Los Angeles, California
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15
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Luk TT, Lam TH, Leung WC, Leung KY, Cheung KW, Kwa C, Siong KH, Tang KK, Lee KW, Hsieh CJ, Wu YS, Li WHC, Wang MP. Brief Advice, Nicotine Replacement Therapy Sampling, and Active Referral for Expectant Fathers Who Smoke Cigarettes: A Randomized Clinical Trial. JAMA Intern Med 2021; 181:1081-1089. [PMID: 34125135 PMCID: PMC8204256 DOI: 10.1001/jamainternmed.2021.2757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Pregnancy presents an opportunity to engage expectant fathers in smoking cessation, but evidence from randomized clinical trials is scarce. OBJECTIVE To evaluate the effectiveness of a proactive, combined intervention for smoking cessation in expectant fathers. DESIGN, SETTING, AND PARTICIPANTS This pragmatic randomized clinical trial in prenatal clinics in 7 public hospitals in Hong Kong proactively recruited and enrolled 1053 participants from October 10, 2018, to February 8, 2020. Included male adults were 18 years or older, smoked cigarettes daily in the past 3 months, had partners who were pregnant and nonsmoking in the past 30 days, and had a landline or mobile telephone number for follow-up. These participants were randomized to either the intervention group or the control group. The primary analyses used an intention-to-treat approach. INTERVENTIONS The intervention group received brief cessation advice, a 1-week free sample of nicotine replacement therapy (NRT), and active referral to a community-based smoking cessation service. The control group received only brief cessation advice with a leaflet on the hazards of perinatal exposure to tobacco smoke and the toll-free quitline telephone number. MAIN OUTCOMES AND MEASURES The primary outcome was biochemically validated tobacco abstinence at 6 months after intervention initiation defined by an exhaled carbon monoxide level of 3 parts per million or lower. The secondary outcomes included self-reported 24-week continuous abstinence at 6 months after intervention initiation as well as 7-day point prevalence abstinence, use of any NRT, and use of a smoking cessation service at 3 and 6 months after intervention initiation. RESULTS All 1053 randomized participants were male adults with a mean (SD) age of 33.8 (6.9) years. The retention rate at 6-month follow-up was 80.7%. The primary outcome of biochemically validated tobacco abstinence at 6 months after intervention initiation was significantly higher in the intervention group than in the control group (6.8% [36 of 527 participants] vs 3.6% [19 of 526]; odds ratio [OR], 1.96; 95% CI, 1.11-3.46; P = .02). The main secondary outcomes of self-reported 24-week continuous abstinence at 6 months (OR, 1.87; 95% CI, 1.08-3.23; P = .03) and 7-day point prevalence abstinence at 3 months (OR, 1.48; 95% CI, 1.05-2.09; P = .03) and 6 months (OR, 1.74; 95% CI, 1.29-2.34; P < .001) were also significantly higher in the intervention group. The intervention group had a significantly higher increase in perceived family harmony (score range, 0-10, with a higher score indicating a higher level of harmony) from baseline to 6 months (B = 0.28; 95% CI, 0.063-0.50; P = .01). CONCLUSIONS AND RELEVANCE This trial found that combining brief advice with a 1-week sample of NRT and referral to smoking cessation programs nearly doubled the odds that expectant fathers who smoked would achieve validated abstinence compared with providing brief advice alone. The intervention was also effective in promoting family harmony. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03671707.
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Affiliation(s)
- Tzu Tsun Luk
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Wing Cheong Leung
- Department of Obstetrics and Gynecology, Kwong Wah Hospital, Hong Kong SAR, China
| | - Kwok-Yin Leung
- Department of Obstetrics and Gynecology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Ka Wang Cheung
- Department of Obstetrics and Gynecology, Queen Mary Hospital, Hong Kong SAR, China
| | - Carina Kwa
- Department of Obstetrics and Gynecology, United Christian Hospital, Hong Kong SAR, China
| | - Kar-Hung Siong
- Department of Obstetrics and Gynecology, Tuen Mun Hospital, Hong Kong SAR, China
| | - Kwok-Keung Tang
- Department of Obstetrics and Gynecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - Kai-Wan Lee
- Department of Obstetrics and Gynecology, Princess Margaret Hospital, Hong Kong SAR, China
| | - Chi Ju Hsieh
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Yongda Socrates Wu
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - William Ho-Cheung Li
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
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16
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Fuemmeler BF, Dozmorov MG, Do EK, Zhang J(J, Grenier C, Huang Z, Maguire RL, Kollins SH, Hoyo C, Murphy SK. DNA Methylation in Babies Born to Nonsmoking Mothers Exposed to Secondhand Smoke during Pregnancy: An Epigenome-Wide Association Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:57010. [PMID: 34009014 PMCID: PMC8132610 DOI: 10.1289/ehp8099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/09/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Maternal smoking during pregnancy is related to altered DNA methylation in infant umbilical cord blood. The extent to which low levels of smoke exposure among nonsmoking pregnant women relates to offspring DNA methylation is unknown. OBJECTIVE This study sought to evaluate relationships between maternal prenatal plasma cotinine levels and DNA methylation in umbilical cord blood in newborns using the Infinium HumanMethylation 450K BeadChip. METHODS Participants from the Newborn Epigenetics Study cohort who reported not smoking during pregnancy had verified low levels of cotinine from maternal prenatal plasma (0 ng / mL to < 4 ng / mL ), and offspring epigenetic data from umbilical cord blood were included in this study (n = 79 ). Multivariable linear regression models were fit to the data, controlling for cell proportions, age, race, education, and parity. Estimates represent changes in response to any 1 -ng / mL unit increase in exposure. RESULTS Multivariable linear regression models yielded 29,049 CpGs that were differentially methylated in relation to increases in cotinine at a 5% false discovery rate. Top CpGs were within or near genes involved in neuronal functioning (PRKG1, DLGAP2, BSG), carcinogenesis (FHIT, HSPC157) and inflammation (AGER). Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses suggest cotinine was related to methylation of gene pathways controlling neuronal signaling, metabolic regulation, cell signaling and regulation, and cancer. Further, enhancers associated with transcription start sites were enriched in altered CpGs. Using an independent sample from the same study population (n = 115 ), bisulfite pyrosequencing was performed with infant cord blood DNA for two genes within our top 20 hits (AGER and PRKG1). Results from pyrosequencing replicated epigenome results for PRKG1 (cg17079497, estimate = - 1.09 , standard error ( SE ) = 0.45 , p = 0.018 ) but not for AGER (cg09199225; estimate = - 0.16 , SE = 0.21 , p = 0.44 ). DISCUSSION Secondhand smoke exposure among nonsmoking women may alter DNA methylation in regions involved in development, carcinogenesis, and neuronal functioning. These novel findings suggest that even low levels of smoke exposure during pregnancy may be sufficient to alter DNA methylation in distinct sites of mixed umbilical cord blood leukocytes in pathways that are known to be altered in cord blood from pregnant active smokers. https://doi.org/10.1289/EHP8099.
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Affiliation(s)
- Bernard F. Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Mikhail G. Dozmorov
- Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Pathology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Elizabeth K. Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Junfeng (Jim) Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Carole Grenier
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
| | - Zhiqing Huang
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
| | - Rachel L. Maguire
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
- Department of Biological Sciences, Center for Human Health and the Environment North Carolina State University, Raleigh, North Carolina, USA
| | - Scott H. Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment North Carolina State University, Raleigh, North Carolina, USA
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
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Jafari A, Rajabi A, Gholian-Aval M, Peyman N, Mahdizadeh M, Tehrani H. National, regional, and global prevalence of cigarette smoking among women/females in the general population: a systematic review and meta-analysis. Environ Health Prev Med 2021; 26:5. [PMID: 33419408 PMCID: PMC7796590 DOI: 10.1186/s12199-020-00924-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/20/2020] [Indexed: 02/07/2023] Open
Abstract
Background This systematic and meta-analysis review aimed to provide an updated estimate of the prevalence of ever and current cigarette smoking in women, in geographic areas worldwide, and demonstrate a trend of the prevalence of smoking over time by using a cumulative meta-analysis. Methods Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of ever and current cigarette smoking in women. We searched PubMed, Web of Science (ISI), Scopus, and Ovid from January 2010 to April 2020. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence of ever and current cigarette smoking in women. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression. Results The pooled prevalence of ever and current cigarette smoking in women was 28% and 17%, respectively. The pooled prevalence of ever cigarette smoking in adolescent girls/students of the school, adult women, pregnant women, and women with the disease was 23%, 27%, 32%, and 38%, respectively. The pooled prevalence of ever cigarette smoking in the continents of Oceania, Asia, Europe, America, and Africa was 36%, 14%, 38%, 31%, and 32%, respectively. Conclusions The prevalence of cigarette smoking among women is very high, which is significant in all subgroups of adolescents, adults, and pregnant women. Therefore, it is necessary to design and implement appropriate educational programs for them, especially in schools, to reduce the side effects and prevalence of smoking among women. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-020-00924-y.
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Affiliation(s)
- Alireza Jafari
- Department of Health Education and Health Promotion, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolhalim Rajabi
- Biostatistics and Epidemiology Department, Faculty of Health, Environmental Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahdi Gholian-Aval
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Peyman
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrsadat Mahdizadeh
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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18
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Rault E, Garabedian C. [Passive Smoking and Pregnancy - CNGOF-SFT Expert Report and Guidelines for Smoking Management during Pregnancy]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2020; 48:578-582. [PMID: 32247095 DOI: 10.1016/j.gofs.2020.03.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The objective of this chapter is to evaluate the risks of second-hand-smoke during pregnancy and to assess the benefits of antenatal care. METHODS Bibliographical research in French and English using the Medline and Cochrane databases and the recommendations of international societies. RESULTS Exposure to second-hand smoke appears to be higher at home and in the car, with potential consequences for pregnancy, especially prematurity (NP3). Complete avoidance of smoking at home significantly reduces exposure to passive smoking compared to incomplete avoidance (NP4). The more numerous the sources, the higher the intoxication is (NP4). The major risk factor associated with passive smoking is the presence of a spouse who smokes. Other associated factors are the presence of a smoker at home or in the car, young population (<25 years), low level of education, old smoking (NP4). Passive smoking is associated with an increased risk of fetal death in utero, fetal malformations, prematurity and birth weight under 2500g (NP2). No specific management is recommended for all pregnant women. Nevertheless, in a specific population of pregnant women with vulnerabilities, a behavioral approach aimed at teaching them to negotiate with their entourage may be beneficial in order to reduce the effects of passive smoking on pregnancy (NP2). CONCLUSION It is recommended to advise women and their family (especially spouses) to create a smoke-free environment, especially at home and in the car (professional consensus). It is recommended to provide a minimum amount of smoking cessation advice to pregnant women's entourage (professional consensus).
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Affiliation(s)
- E Rault
- Service d'obstétrique, hôpital Femme-Mère-Enfant Lyon, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France.
| | - C Garabedian
- Clinique d'obstétrique, CHU Lille, 59000 Lille, France
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19
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Gould GS, Havard A, Lim LL, Kumar R. Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2034. [PMID: 32204415 PMCID: PMC7142582 DOI: 10.3390/ijerph17062034] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/13/2020] [Accepted: 03/14/2020] [Indexed: 12/15/2022]
Abstract
The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers to and facilitators of smoking cessation during pregnancy. Two databases were searched to obtain systematic reviews published from 2010 to 2019. Pertinent data from 76 articles were summarized using a narrative synthesis (PROSPERO reference: CRD42018085896). Exposure to smoke or tobacco in other forms during pregnancy is associated with an increased risk of obstetric complications and adverse health outcomes for children exposed in-utero. Counselling interventions are modestly effective, while incentive-based interventions appear to substantially increase smoking cessation. Nicotine replacement therapy is effective during pregnancy but the evidence is not conclusive. Predictors and barriers to smoking cessation in pregnancy are also discussed. Smoking during pregnancy poses substantial risk to mother's and child's health. Psychosocial interventions and nicotine replacement therapy (NRT) appear to be effective in helping pregnant women quit smoking. Barriers to smoking cessation must be identified and steps taken to eradicate them in order to reduce smoking among pregnant women. More research is needed on smoking cessation medications and e-cigarettes.
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Affiliation(s)
- Gillian S. Gould
- School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, Australia; (L.L.L.); (R.K.)
| | - Alys Havard
- Centre for Big Data Research in Health, UNSW Sydney, Sydney NSW 2052, Australia;
| | - Ling Li Lim
- School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, Australia; (L.L.L.); (R.K.)
| | | | - Ratika Kumar
- School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, Australia; (L.L.L.); (R.K.)
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20
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Frazer K, Fitzpatrick P, Brosnan M, Dromey AM, Kelly S, Murphy M, O’Brien D, Kelleher CC, McAuliffe FM. Smoking Prevalence and Secondhand Smoke Exposure during Pregnancy and Postpartum-Establishing Risks to Health and Human Rights before Developing a Tailored Programme for Smoking Cessation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061838. [PMID: 32178339 PMCID: PMC7142815 DOI: 10.3390/ijerph17061838] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/05/2020] [Accepted: 03/05/2020] [Indexed: 01/10/2023]
Abstract
Both smoking during pregnancy and secondhand smoke exposure are associated with reduced health outcomes. However, limited consistent evidence exists of risks of secondhand smoke exposure in pregnancy. Currently, inadequate smoking cessation services exist in Irish maternity hospitals. To identify the number of pregnant women smoking during pregnancy and to identify their exposure to secondhand smoke, we conducted a cross-sectional observational pilot study in one regional maternity hospital in Ireland in July/August 2018. Respondents were (1) women attending antenatal clinics and (2) postpartum women before discharge. Variables measured included smoking status of pregnant women and partner status, demographic variables, secondhand smoke exposure, and support for hospital smoke-free policy and development of smoking cessation services. The overall response rate was 42.2% in this study. The response rate was 56.5% (111/196) from postnatal wards and 37.3% (215/577) from antenatal clinics. Over 40% of respondents reported they had smoked during their lifetime. The majority of women (70%) reported quitting smoking before their pregnancy. Few women were active smokers. Almost 40% reported exposure to tobacco smoke in the previous week (38.5%); 16.9% reported living with a smoker, a critical factor in increased risk (Odds Ratio (OR) 3.89, 95% CI = 1.86-8.15, p < 0.001). Approximately 10% of postnatal mothers reported that their newborn would travel home with a smoker. Support for a no-smoking hospital policy was very high as was support for the development of cessation services. No documentation of secondhand smoke exposure for pregnant women or newborns is sought or recorded routinely in the hospital. A systems approach to develop smoking cessation programmes in maternity care should include screening and documenting of secondhand smoke exposure risks for women during pregnancy, and for their newborns at discharge, to improve health outcomes and protect human rights.
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Affiliation(s)
- Kate Frazer
- School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4, Ireland
- Correspondence:
| | - Patricia Fitzpatrick
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland
- Department of Preventive Medicine & Health Promotion, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
| | - Mary Brosnan
- National Maternity Hospital, Holles Street, Dublin 2, Ireland
| | - Anne Marie Dromey
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Sarah Kelly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Michael Murphy
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
| | - Denise O’Brien
- School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4, Ireland
| | - Cecily C. Kelleher
- Department of Preventive Medicine & Health Promotion, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
- University College Dublin, College of Health and Agricultural Sciences, Woodview House, Belfield, Dublin 4, Ireland
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland
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21
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Nighbor TD, Coleman SRM, Bunn JY, Kurti AN, Zvorsky I, Orr EJ, Higgins ST. Smoking prevalence among U.S. national samples of pregnant women. Prev Med 2020; 132:105994. [PMID: 31952968 PMCID: PMC7024639 DOI: 10.1016/j.ypmed.2020.105994] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/01/2019] [Accepted: 01/13/2020] [Indexed: 11/30/2022]
Abstract
Several data sources exist for estimating U.S. smoking prevalence among pregnant women, yet each differs in ways that have the potential to impact the estimates. In the present study we used the Population Assessment of Tobacco and Health (PATH), the National Survey on Drug use and Health (NSDUH), and the Pregnancy Risk Assessment Monitoring System (PRAMS), three common data sources, to evaluate the following questions about estimating U.S. smoking prevalence among pregnant women: To what extent are estimates impacted by differences in whether the samples include younger (<18 years) or older (>44 years) women, represent smoking in any trimester or only the 3rd, and use data from nationally representative or more selected national samples. Among the factors examined, inclusion of younger or older women does not appear to meaningfully alter prevalence estimates. Focusing on only the third trimester likely underestimates smoking prevalence, while the influence of basing estimates on selected national subgroups of women (i.e., only women who delivered live born infants) rather than nationally representative surveys has little discernible influence. Going forward, this research area would benefit from greater consistency in explicitly discussing the sampling methods used and how these various methods may have influenced the estimates reported.
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Affiliation(s)
- Tyler D Nighbor
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America
| | - Sulamunn R M Coleman
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America
| | - Janice Y Bunn
- Department of Medical Biostatistics, University of Vermont, United States of America
| | - Allison N Kurti
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America; Department of Psychological Science, University of Vermont, United States of America
| | - Ivori Zvorsky
- Vermont Center on Behavior and Health, United States of America; Department of Psychological Science, University of Vermont, United States of America
| | - Eva J Orr
- Vermont Center on Behavior and Health, United States of America
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America; Department of Psychological Science, University of Vermont, United States of America.
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