Tobacco use, secondhand smoke exposure during pregnancy, may threaten health of women and children

In developing nations

This release is available in Spanish.

Findings from a National Institute of Health (NIH) study indicate that rates of tobacco use during pregnancy, as well as exposure of pregnant women and their young children to secondhand smoke, are significant threats to health in several low and middle-income countries. In a few of the countries sampled, including some in Latin America, rates of tobacco-related exposures may already be high enough to warrant substantial concern. Findings from the study, which is the first to examine pregnant women’s tobacco use, second-hand smoke exposure and attitudes toward women’s tobacco use in multiple developing countries, will appear in the April 2008, issue of the American Journal of Public Health, with advance online publication on February 28, 2008.

Historically, the prevalence of smoking among women in the developing world has been very low, in part because of strong cultural constraints against women’s tobacco use. “This study indicates that public health officials in developing nations should take immediate steps to prevent and reduce tobacco use and secondhand smoke exposure among pregnant women,” said Duane Alexander, M.D., Director of the National Institute of Child Health and Human Development (NICHD). “This should include efforts to better understand the scope of the problem, so as to best direct public health interventions.”

The study was conducted by an international team of investigators, including researchers from the National Cancer Institute (NCI) and NICHD, two NIH institutes. The researchers conducted the study at ten sites in the NICHD Global Network for Women’s and Children’s Health Research, which focuses on improving maternal and child health in the developing world. Approximately 8,000 pregnant women were surveyed at five sites in Latin America (Argentina, Uruguay, Ecuador, Brazil and Guatemala), two sites in Africa (Zambia and the Democratic Republic of the Congo) and three sites in Asia (two in India and one in Pakistan). The survey looked at pregnant women’s use of tobacco products (cigarettes and smokeless tobacco), their perceptions of the social acceptability of tobacco use for women, and exposure to secondhand smoke experienced by them and their young children.

“Preventing an increase in tobacco use by women in the developing world is widely recognized as a significant public health opportunity,” said lead author Michele Bloch, M.D., Ph.D., of NCI’s Tobacco Control Research Branch. “Our results demonstrate that pregnant women’s tobacco use and exposure to secondhand smoke threaten to impede or reverse ongoing efforts to improve maternal and child health in the developing world.”