Cent Eur J Public Health 2018, 26(3):164-170 | DOI: 10.21101/cejph.a5048

Continued smoking versus spontaneous quitting among pregnant women living in a high risk environment

Peter Balázs1, Andrea Grenczer2, Ildiko Rákóczi3, Kristie L. Foley4
1 Institute of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
2 Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
3 Debrecen-Nyiregyhaza University, Debrecen, Hungary
4 Wake Forest University Medical School, Comprehensive Cancer Center, Winston-Salem, NC, USA

Objectives: In Hungary, 37% of women living in poverty were smokers in 2012. There are no valid data of pregnant women's spontaneous smoking cessation.

Methods: Our retrospective cohort study (2009-2012) targeted the most underdeveloped regions with an estimated 6-8.5% of Roma population. The sample (N = 12,552) represented 76% of the target population i.e. women in four counties in a year delivering live born babies. Chi-square probe and multivariable logistic regression model (p < 0.05) were used to assess relationship between socio-demographic characteristics and spontaneous cessation.

Results: Prior to pregnancy, the overall smoking rate was 36.8%. That of women in deep poverty and Roma was 49.7% and 51.1%, respectively. 70.3% of smokers continued smoking during the pregnancy. Among them 80.6% lived in deep poverty. Spontaneous quitting rate was 23.0%. Factors correlated with continued smoking included being Roma (OR = 1.95), undereducated (OR = 2.66), living in homes lacking amenities (OR = 1.48), and having regularly smoking partner (OR = 2.07). Cessation was promoted by younger age (≤ 18 years) (OR = 0.18), being married (OR = 0.50), and the first pregnancy.

Conclusions: Tailored cessation programmes are needed for Roma, older, low-income, and multiparous women who are less likely to quit on their own. Engaging husbands/partners is essential to reduce smoking among pregnant women and second-hand smoke exposure.

Klíčová slova: tobacco smoking, pregnant women, spontaneous quitting, high risk environment, Roma population

Vloženo: 27. leden 2017; Revidováno: 31. srpen 2018; Zveřejněno: 30. září 2018  Zobrazit citaci

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Balázs P, Grenczer A, Rákóczi I, Foley KL. Continued smoking versus spontaneous quitting among pregnant women living in a high risk environment. Cent Eur J Public Health. 2018;26(3):164-170. doi: 10.21101/cejph.a5048. PubMed PMID: 30419616.
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    Reference

    1. Ko TJ, Tsai LY, Chu LC, Yeh SJ, Leung C, Chen CY, et al. Parental smoking during pregnancy and its association with low birth weight, small for gestational age, and preterm birth offspring: a birth cohort study. Pediatr Neonatol. 2014 Feb;55(1):20-7. Přejít k původnímu zdroji... Přejít na PubMed...
    2. Räisänen S, Kramer MR, Gissler M, Saari J, Hakulinen-Viitanen T, Heinonen S. Smoking during pregnancy was up to 70% more common in the most deprived municipalities - a multilevel analysis of all singleton births during 2005-2010 in Finland. Prev Med. 2014 Oct;67:6-11. Přejít k původnímu zdroji... Přejít na PubMed...
    3. Vivilaki VG, Diamanti A, Tzeli M, Patelarou E, Bick D, Papadakis S, et al. Exposure to active and passive smoking among Greek pregnant women. Tob Induc Dis. 2016 Apr;14:12. doi: 10.1186/s12971-016-0077-8. Přejít k původnímu zdroji... Přejít na PubMed...
    4. Paulik E, Nagymajtényi L, Easterling D, Rogers T. Smoking behaviour and attitudes of Hungarian Roma and non-Roma population towards tobacco control policies. Int J Public Health. 2011 Oct;56(5):485-91. Přejít k původnímu zdroji... Přejít na PubMed...
    5. Bobak M, Dejmek J, Solansky I, Sram RJ. Unfavourable birth outcomes of the Roma women in the Czech Republic and the potential explanations: a population-based study. BMC Public Health. 2005 Oct 10;5:106. doi:10.1186/1471-2458-5-106. Přejít k původnímu zdroji... Přejít na PubMed...
    6. Rambousková J, Dlouhý P, Krízová E, Procházka B, Hrncírová D, Andel M. Health behaviors, nutritional status, and anthropometric parameters of Roma and non-Roma mothers and their infants in the Czech Republic. J Nutr Educ Behav. 2009 Jan-Feb;41(1):58-64. Přejít k původnímu zdroji... Přejít na PubMed...
    7. Balázs P, Rákóczi I, Grenczer A, Foley KL. Birth-weight differences of Roma and non-Roma neonates - public health implications from a population-based study in Hungary. Cent Eur J Public Health. 2014 Mar;22(1):24-8. Přejít k původnímu zdroji... Přejít na PubMed...
    8. Meghea CI, Rus D, Rus IA, Summers Holtrop J, Roman L. Smoking during pregnancy and associated risk factors in a sample of Romanian women. Eur J Public Health. 2012 Apr;22(2):229-33. Přejít k původnímu zdroji... Přejít na PubMed...
    9. European Commission. An EU framework for national Roma integration strategies up to 2020: Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions [Internet]. Brussels; 2011 [cited 2018 Aug 31]. Available from: https://www.google.com/search?q=An+EU+framework+for+national+Roma+integration+strategies+up+to+2020&ie=utf-8&oe=utf-8&client=firefox-b.
    10. Census National Data, 2011 [Internet]. Budapest: Hungarian Central Statistical Office; 2014 [cited 2018 Aug 31]. Available from: http://www.ksh.hu/docs/hun/xftp/idoszaki/nepsz2011/nepsz_09_2011.pdf. (In Hungarian.)
    11. World Health Organization. WHO Framework Convention on Tobacco Control [Internet]. Geneva: WHO; 2003 [cited 2018 Aug 31]. Available from: http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf.
    12. Lomnici Z. Hungary's legal regulation of smoking from the Austro-Hungarian conciliation till present days. In: Increasing capacity for tobacco research in Hungary, 2008-2013. Budapest: Institute for the History of Hungarian Séciences; 2013. p. 215-32.
    13. WHO Regional Office for Europe. Tobacco control in practice. Article 8: Protection from exposure to tobacco smoke: the story of Hungary [Internet]. Copenhagen: WHO; 2014 [cited 2018 Aug 31]. Available from: http://www.euro.who.int/__data/assets/pdf_file/0020/263333/Tobacco-control-in-practice-Article-8-Protection-from-exposure-to-tobacco-smoke-the-story-of-Hungary.pdf?ua=1.
    14. Vicedo-Cabrera AM, Schindler C, Radovanovic D, Grize L, Witassek F, Dratva J, et al. Benefits of smoking bans on preterm and early-term births: a natural experimental design in Switzerland. Tob Control. 2016 Dec;25(e2):e135-41. Přejít k původnímu zdroji... Přejít na PubMed...
    15. World Health Organization, Regional Office for Europe. Hungary releases new data on the social burden of smoking [Internet]. Copenhagen: WHO Regional Office for Europe; 2012 [cited 2018 Aug 31]. Available from: http://www.euro.who.int/en/countries/hungary/news/news/2012/06/hungary-releases-new-data-on-the-social-burden-of-smoking.
    16. National Institute for Health Development, Hungarian Focal Point for Tobacco Control. Hungarian and foreign data & statistics [Internet]. 2014 [cited 2018 Aug 31]. Available from: http://www.fokuszpont.dohanyzasvisszaszoritasa.hu/en/content/hungarian-and-foreign-data-statistics.
    17. Central Statistical Office of Hungary [Internet]. 2014 [cited 2018 Aug 31]. Available from: http://www.ksh.hu/interaktiv/terkepek/mo/gdp_eng.html.
    18. Rice VH, Stead LF. Nursing interventions for smoking cessation. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD001188. doi: 10.1002/14651858.CD001188.pub3. Přejít k původnímu zdroji... Přejít na PubMed...
    19. Kintz T, Pryor C, Shemami H, Al-Oballi Kridli S. Nursing interventions to promote smoking cessation during pregnancy: An integrative review. J Nurs Educ Pract. 2014;4(9):77-90. Přejít k původnímu zdroji...
    20. Lawson PJ, Flocke SA, Casucci B. Development of an instrument to document the 5A's for smoking cessation. Am J Prev Med. 2009 Sep;37(3):248-54. Přejít k původnímu zdroji... Přejít na PubMed...
    21. World Health Organization. Toolkit for delivering the 5A's and 5R's brief tobacco interventions in primary care. Geneva: WHO; 2014.
    22. Fiore MC, Jaén CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville: U.S. Department of Health and Human Services, Public Health Service; 2008.
    23. Ockene J, Ma Y, Zapka J, Pbert L, Valentine Goins K, Stoddard A. Spontaneous cessation of smoking and alcohol use among low-income pregnant women. Am J Prev Med. 2002 Oct;23(3):150-9. Přejít k původnímu zdroji... Přejít na PubMed...
    24. Morasco BJ, Dornelas EA, Fischer EH, Oncken C, Lando HA. Spontaneous smoking cessation during pregnancy among ethnic minority women: a preliminary investigation. Addict Behav. 2006 Feb;31(2):203-10. Přejít k původnímu zdroji... Přejít na PubMed...
    25. TÁRKI Social Research Institute Inc. Inequalities and polarization in the Hungarian society [Internet]. Budapest, TÁRKI; 2013 [cited 2018 Aug 31]. Available from: http://www.tarki.hu/hu/research/hm/monitor2012_teljes.pdf.
    26. Mohlman MK, Levy DT. Disparities in maternal child and health outcomes attributable to prenatal tobacco use. Matern Child Health J. 2016 Mar;20(3):701-9. Přejít k původnímu zdroji... Přejít na PubMed...
    27. Vianna P, Bauer ME, Dornfeld D, Chies JA. Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol levels and altering lymphocyte sensitivity to glucocorticoids. Med Hypotheses. 2011 Aug;77(2):188-91. Přejít k původnímu zdroji... Přejít na PubMed...
    28. LeWinn KZ, Stroud LR, Molnar BE, Ware JH, Koenen KC, Buka SL. Elevated maternal cortisol levels during pregnancy are associated with reduced childhood IQ. Int J Epidemiol. 2009 Dec;38(6):1700-10. Přejít k původnímu zdroji... Přejít na PubMed...
    29. Pregnancy and postpartum smoking cessation. In: Samet JM, Yoon SY, editors. Gender, women, and the tobacco epidemic. Geneva: WHO; 2010. p. 175-88.
    30. Vokó Z, Csépe P, Németh R, Kósa K, Kósa Z, Széles G, et al. Does socioeconomic status fully mediate the effect of ethnicity on the health of Roma people in Hungary? J Epidemiol Community Health. 2009 Jun;63(6):455-60. Přejít k původnímu zdroji... Přejít na PubMed...
    31. Lerman CE, Schnoll RA, Munafò MR. Genetics and smoking cessation improving outcomes in smokers at risk. Am J Prev Med. 2007 Dec;33(6 Suppl):S398-405. Přejít k původnímu zdroji... Přejít na PubMed...
    32. Kósa K, Lénárt B, Adány R. Health status of the roma population in Hungary. Orv Hetil. 2002 Oct 27;143(43):2419-26. (In Hungarian.) Přejít na PubMed...
    33. Bailey BA. Effectiveness of a pregnancy smoking intervention: The Tennessee Intervention for Pregnant Smokers Program. Health Educ Behav. 2015 Dec;42(6):824-31. Přejít k původnímu zdroji... Přejít na PubMed...

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