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Canadian Journal of Public Health

, Volume 95, Issue 3, pp 209–213 | Cite as

Prevalence of Smoking Associated with Pregnancy in Three Southern Ontario Health Units

  • Ian L. Johnson
  • Mary Jane Ashley
  • Donna Reynolds
  • Fred Goettler
  • Hyewon Lee-Han
  • Julie Stratton
  • Charles Yim
  • Judy Murray
Article

Abstract

Objectives

The objectives of this study were to determine the prevalence of pregnancyassociated smoking among women residing in three Southern Ontario Health Units and to examine potential risk factors for smoking during pregnancy, using an existing data collection mechanism.

Methods

During May 2001, questions about pregnancy-associated smoking were asked during the telephone follow-up of postpartum women living in the three health units in Southern Ontario; this follow-up is routinely conducted by public health nurses. Sociodemographic data were also obtained. Data from 1,134 women were analyzed concerning smoking before and after the occurrence of the pregnancy was known, during each trimester, and immediately postpartum.

Results

The rates of smoking before and after the pregnancy was known, in the first, second, and third trimesters, and immediately postpartum were 17.8%, 10.4%, 9.6%, 8.7%, 8.1%, and 7.9%, respectively. For all six estimates of smoking, Canadian-born women had rates 2.5 to 4 times higher than those of women born outside Canada. Age less than 25 years and lower educational attainment were also independent risk factors for smoking during pregnancy.

Conclusions

The Ontario Tobacco Strategy goal of eliminating smoking in pregnancy has not yet been realized. Ongoing smoking cessation programs among pregnant women are needed as part of a comprehensive strategy to reduce the overall prevalence of smoking. In planning such programs, particular attention should be paid to the needs of women who are Canadian-born, have lower educational attainment, and are under the age of 25.

Résumé

Objectifs

L’étude visait à déterminer la prévalence du tabagisme associé à la grossesse chez des femmes résidant dans trois services de santé du sud de l’Ontario et à examiner les facteurs de risque potentiels du tabagisme durant la grossesse à l’aide d’un mécanisme de collecte de données existant.

Méthode

En mai 2001, nous avons posé des questions sur le tabagisme associé à la grossesse lors d’un suivi téléphonique auprès de femmes ayant accouché et vivant dans les trois services de santé du sud de l’Ontario; il s’agissait du suivi systématiquement effectué par les infirmières de santé publique. Nous avons également obtenu des données socio-démographiques. Nous avons analysé les réponses de 1 134 femmes aux questions sur le tabagisme avant et après l’annonce de la grossesse, à chaque trimestre et tout de suite après l’accouchement.

Résultats

Les taux de tabagisme étaient de 17,8 % avant et de 10,4 % après l’annonce de la grossesse, de 9,6 % au premier trimestre, de 8,7 % au deuxième trimestre, de 8,1 % au troisième trimestre et de 7,9 % tout de suite après l’accouchement. Pour ces six estimations, les femmes nées au Canada avaient des taux de tabagisme de 2,5 à 4 fois supérieurs à ceux des femmes nées à l’étranger. Le fait d’avoir moins de 25 ans et un faible niveau d’instruction étaient aussi des facteurs de risque indépendants du tabagisme durant la grossesse.

Conclusions

L’objectif de la Stratégie antitabac de l’Ontario, qui est d’éliminer le tabagisme durant la grossesse, n’est pas encore atteint. Il faudrait offrir aux femmes enceintes des programmes continus de renoncement au tabac dans le cadre d’une stratégie globale de réduction de la prévalence du tabagisme. En planifiant de tels programmes, il faudrait accorder une attention particulière aux besoins des femmes de moins de 25 ans nées au Canada dont le niveau d’instruction est faible.

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References

  1. 1.
    U.S. Department of Health and Human Services. Women and Smoking. A Report of the Surgeon General. Office of Smoking and Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. Rockville, MD, 2001. (https://doi.org/www.surgeongeneral.gov/library) pp.272–307.Google Scholar
  2. 2.
    Towards Health Outcomes (Goals 2 and 4). Objectives and Targets. Health Goals Committee, Mary Shamley, Chair. Toronto: Premier’s Council on Health Strategy, 1991.Google Scholar
  3. 3.
    Ebrahim SH, Floyd RL, Merritt RK 2nd, Decoufle P, Holtzman D. Trends in pregnancyrelated smoking rates in the United States, 1987–1996. JAMA 2000;283(3):361–66.PubMedCrossRefGoogle Scholar
  4. 4.
    Colman GJ, Joyce T. Trends in smoking before, during, and after pregnancy in ten states. Am J Prev Med 2003;24(1):29–35.PubMedCrossRefGoogle Scholar
  5. 5.
    Ventura SJ, Hamilton BE, Mathews TJ, Chandra A. Trends and variations in smoking during pregnancy and low birth weight: Evidence from the birth certificate, 1990–2000. Pediatrics 2003;111(5 Part 2):1176–80.PubMedGoogle Scholar
  6. 6.
    Connor SK, McIntyre. L. The sociodemographic predictors of smoking cessation among pregnant women in Canada. Can J Public Health 1999;90(5):352–55.PubMedGoogle Scholar
  7. 7.
    Health Canada. Canadian Tobacco Use Monitoring Survey. Wave 1. February to June 2002. Supplementary tables. (https://doi.org/www.gosmokefree.ca/ctums).Google Scholar
  8. 8.
    Kirkland SA, Dodds LA, Brosky G. The natural history of smoking during pregnancy among women in Nova Scotia. CMAJ 2000;63(3):281- 82.Google Scholar
  9. 9.
    Pickett KE, Wakschlag LS, Dai L, Leventhal, BL. Fluctuations of maternal smoking during pregnancy. Obstet Gynecol 2003;01(1):140–47.Google Scholar
  10. 10.
    Statistics Canada, 2001. Census https://doi.org/www12.statcan.ca/english/census01/ products/standard/popdwell/Table-CDP. cfm?PR=35. Accessed on December 11, 2003.Google Scholar
  11. 11.
    MS Access 2000. Microsoft Corporation, 1999.Google Scholar
  12. 12.
    SPSS version 10. SPSS Inc. Headquarters, 233 S. Wacker Drive, 11th floor, Chicago, IL 60606.Google Scholar
  13. 13.
    Stewart PJ, Potter J, Dulberg C, Niday P, Nimrod C, Tawagi G. Change in smoking prevalence among pregnant women 1982–93. Can J Public Health 1995;86(1):37–41.PubMedGoogle Scholar
  14. 14.
    Colman G, Grossman M, Joyce T. The effect of cigarette excise taxes on smoking before, during and after pregnancy. The National Bureau of Economic Research. NBER Working Paper Series. Working Paper 9245. Cambridge, MA. October 2002. https://doi.org/www.nber.org/papers/ w9245.Google Scholar
  15. 15.
    National Cancer Institute. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. The Report of the U. S. Environmental Protection Agency. Smoking and Tobacco Control, Monograph, no. 4. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. NIH Publication, No. 93–3605, 1993.Google Scholar
  16. 16.
    National Cancer Institute. Health Effects of Exposure to Environmental Tobacco Smoke. The Report of the California Environmental Protection Agency. Smoking and Tobacco Control, Monograph, no. 10. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. NIH Publication, No. 99–4645, 1999.Google Scholar
  17. 17.
    Ontario Tobacco Research Unit. Monitoring the Ontario Tobacco Strategy. 8th Annual Monitoring Report. Part 3. Indicators of Progress 2001/2002. Toronto, ON, November 2002.Google Scholar
  18. 18.
    Paterson JM, Neimanis IM, Bain E. Stopping smoking during pregnancy: Are we on the right track? Can J Public Health 2003;94(4):297–99.PubMedGoogle Scholar
  19. 19.
    Kahn RS, Certain L, Whitaker, RC. A reexamination of smoking before, during, and after pregnancy. Am J Public Health 2002;92(11):1801–8.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Penn G, Owen L. Factors associated with continued smoking during pregnancy: Analysis of sociodemographic, pregnancy, and smoking-related factors. Drug Alcohol Rev 2002;21(1):17–25.PubMedCrossRefGoogle Scholar
  21. 21.
    Millar, WJ. Place of birth and ethnic status: Factors associated with smoking prevalence among Canadians. Health Rep 1992;4(1):7–24.PubMedGoogle Scholar
  22. 22.
    Boyd NR, Windsor RA, Perkins LL, Lowe, JB. Quality of measurement of smoking status by self-report and saliva cotinine among pregnant women. Matern Child Health J 1998;2(2):77–83.PubMedCrossRefGoogle Scholar
  23. 23.
    Lindqvist R, Lendahls L, Tollbom O, Aberg H, Hakansson A. Smoking during pregnancy: Comparison of self-reports and cotinine levels in 496 women. Acta Obstet Gynecol Scand 2002;81(3):240–44.PubMedCrossRefGoogle Scholar
  24. 24.
    Klebanoff MA, Levine RJ, Morris CD, Hauth JC, Sibai BM, Ben Curet L, et, al. Accuracy of self-reported cigarette smoking among pregnant women in the 1990s. Paediatr Perinat Epidemiol 2001;15(2):140–43.PubMedCrossRefGoogle Scholar
  25. 25.
    Mills C, Stephens T, Wilkins K. Summary report of the workshop on data for monitoring tobacco use. Health Rep 1994;6(3):377–87.PubMedGoogle Scholar

Copyright information

© The Canadian Public Health Association 2004

Authors and Affiliations

  • Ian L. Johnson
    • 1
    • 2
  • Mary Jane Ashley
    • 1
    • 2
  • Donna Reynolds
    • 1
    • 3
  • Fred Goettler
    • 4
  • Hyewon Lee-Han
    • 5
  • Julie Stratton
    • 6
  • Charles Yim
    • 4
  • Judy Murray
    • 3
  1. 1.Department of Public Health Sciences, Faculty of MedicineUniversity of TorontoTorontoCanada
  2. 2.Ontario Tobacco Research Unit, Dept. of Public Health SciencesUniversity of TorontoCanada
  3. 3.Durham Region Health UnitCanada
  4. 4.City of Toronto Health UnitCanada
  5. 5.Canada
  6. 6.Peel Region Health UnitCanada

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