Maternal and Child Health Journal

, Volume 7, Issue 3, pp 179–186 | Cite as

Demographic and Psychosocial Profile of Smoking Among Pregnant Women in Lebanon: Public Health Implications

  • Monique Chaaya
  • Johnny Awwad
  • Oona M.R. Campbell
  • Abla Sibai
  • Afamia Kaddour


Objectives: To assess the prevalence and determinants of smoking prior to and during pregnancy in Lebanon. Methods: A cross-sectional study using two structured instruments. One instrument included information on demographic characteristics, smoking patterns in the index pregnancy and previous pregnancies, use of prenatal health services, stressful life events, and social support during pregnancy. The second was the Arabic General Health Questionnaire (GHQ-12). Women who delivered in 11 randomly selected hospitals in Beirut and its suburbs within 24 hours were asked to consent to participate in the study. The total sample interviewed was 576 women. Results: The prevalence of pre-pregnancy smoking was 32% and 20% for smoking in pregnancy. Considering argileh smoking, the prevalence of tobacco use in pregnancy increased to 27% in Beirut and 25% in the suburbs. Pre-pregnancy smoking was associated with older maternal age [OR = 1.08, 95% CI (1.03, 1.14)], low and medium education [OR = 2.22, 95% CI (1.22, 4.04)], increased psychiatric distress [OR = 3.11, 95% CI (1.77, 5.46)], and a husband who smoked [OR = 5.00, 95% CI (2.98, 8.39)]. Continued smoking during pregnancy was associated with low and medium education [OR = 3.77, 95% CI (1.31, 10.8)], younger age [OR = 1.11, 95% CI (1.02–1.20)], and a heavy pre-pregnancy smoking pattern [OR = 13.9, 95% CI (1.40, 137.4)]. Conclusion: Policies and programs to eliminate or reduce smoking during pregnancy should be targeted toward young and less educated females and involving the spouse. Obstetricians should promote smoking cessation during pregnancy using evidence-based methods.

smoking pregnancy psychosocial factors obstetric factors argileh Lebanon 


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  1. 1.
    Steer P, Flint C. Preterm labour and premature rupture of the membranes. Br Med J 1999;318:1059.Google Scholar
  2. 2.
    Pinorini Godly MT, Myres SR. HPLC and GC/MS determination of 4-aminobiphenyl haemoglobin adducts in fetuses exposed to the tobacco smoke carcinogen in utero. Toxicology 1996;107:209-17.Google Scholar
  3. 3.
    Horta BL, Victora CG, Menezes AM, Barros FC. Environmental tobacco smoke and breastfeeding duration. Am J Epidemiol 1997;146(2):128-33.Google Scholar
  4. 4.
    Chollat Tarquet C. Women and Tobacco. Geneva: World Health Organization, 1992.Google Scholar
  5. 5.
    Pritchard CW. Depression and smoking in pregnancy inScotland. J Epidemiol Community Health 1994;48:377-82.Google Scholar
  6. 6.
    Lumley J, Oliver S, Waters E. Interventions for promoting smoking cessation during pregnancy (Cochrane Review). The Cochrane Library. Oxford, Update Software, issue 3, 2000.Google Scholar
  7. 7.
    Cnattingius S, Gunilla, and Meirik O. Who continues to smoke while pregnant? J Epidemiol Community Health 1992;46:218-221.Google Scholar
  8. 8.
    Dejin Karlsson E, Hanson BS, Ostergren PO, Ranstam J,Isacsson SO, Sjoberg NO. Psychosocial resources and persistent smoking in early pregnancy—a population study of women in their first pregnancy in Sweden. J Epidemiol Community Health 1996;50:33-9.Google Scholar
  9. 9.
    World Health Organization. Mother-baby package: Implementing safe motherhood in countries. Geneva, Switzerland, World Health Organization, Division of Family Health, Maternal Health and Safe Motherhood Programme, 1994 (Safe Motherhood Practical Guide, xxi, 89).Google Scholar
  10. 10.
    Etudes et Consultations Economiques. Investor's Guide. Beirut, Etudes et Consultations Economiques, 1998.Google Scholar
  11. 11.
    United Nations Development Programme. Arab Human Development Report: Creating opportunities for future generations. New York, USA: UNDP, 2002.Google Scholar
  12. 12.
    Zurayk HC. Armenian HK editors Beirut 1984: A population and health profile. Beirut: American University of Beirut; 1995.Google Scholar
  13. 13.
    Deeb ME editor. Beirut: A health profile 1984-1994. Beirut: American University of Beirut; 1997.Google Scholar
  14. 14.
    Nuwayhid IA, Yamout B, Azar G, Kambris MA. Narghile (hubble-bubble) smoking, low birth weight, and other pregnancy outcomes. Am J Epidemiol 1998;148:375-83.Google Scholar
  15. 15.
    Ministry of Social Affairs. Population and Household Survey. Beirut Ministry of Social Affairs and UNFPA, 1996.Google Scholar
  16. 16.
    PAPCHILD. Preliminary Report. Lebanon: Ministry of Health, 1996.Google Scholar
  17. 17.
    Goldberg D. Manual of the General Health Questionnaire. Windsor, UK:, NFER Publishing Company, 1978.Google Scholar
  18. 18.
    El Rufaie OF, Daradkeh TK. Validation of the Arabic versions of the thirty-and twelve-item General Health Questionnaire. Br J Psychiatry 1996;169:662-4.Google Scholar
  19. 19.
    Farhood L, Zurayk H, Chaya M, Saadeh F, Meshefedjian G, Sidani T. The impact of war on the physical and mental health of the family: The Lebanese experience. Soc Sci Med 1993;36:1555-1567.Google Scholar
  20. 20.
    Chaaya M, Campbell O, El-Kak F, Shaar D, Harb H, Kaddour A. Postpartum depression: Prevalence and determinants in Lebanon. Arch Women's Mental Health 2002;5:65-72.Google Scholar
  21. 21.
    Norusis MJ. SPSS/PC+ Advanced Statistics 4.0. Chicago: SPSS, Inc., 1990.Google Scholar
  22. 22.
    United Nations Children's Fund (UNICEF). National Perinatal Survey, Lebanon 1999-2000. UNICEF and Ministry of Public Health, 2000.Google Scholar
  23. 23.
    Najdawi F, Faouri M. Maternal smoking and breastfeeding. East Mediterr Health J 1999;5:450-6.Google Scholar
  24. 24.
    Eriksson KM, Haug K, Salvesen KA, Nesheim BI, Nylander G, Rasmussen S, Andersen K, Nakling JO, Eik-Nes SH. Smoking habits among pregnant women in Norway 1994-95. Acta Obstet Gynecol Scand 1998;77:159-164.Google Scholar
  25. 25.
    Wisborg K, Henriksen TB, Hedegaard M, Secher NJ. Smoking habits among Danish pregnant women from 1989 to 1996 in relation to sociodemographic and lifestyle factors. Acta Obstet Gynecol Scand 1998;77:836-40.Google Scholar
  26. 26.
    Abou Al Zahab B. National Survey of Tobacoo Smoking. Directorate of Primary Health Care, Program of Tobacco Control, WHO and The Ministry of Health. Damascus 2001.Google Scholar
  27. 27.
    Ebrahim SH, Floyd RL, Merritt RK, Decoulfle P, Holtzman D. Trends in pregnancy-related smoking rates in the United States, 1987-1996. J Am Med Assoc 2000;283:361-367.Google Scholar
  28. 28.
    Chidiac C. The profile of the Lebanese smoker: Prevalence, characteristics and risk factors. Unpublished Thesis. USJ, 1998.Google Scholar
  29. 29.
    Ministry of Public Health. National Household Health Expenditure and Utilization Survey (NHHEUS), 1999.Google Scholar
  30. 30.
    O'Campo P, Faden RR, Brown H, Carlson Gielen A. The impact of pregnancy on women's prenatal and postpartum smoking behavior. Am J Prev Med 1992;8:8-13.Google Scholar
  31. 31.
    Parazzini F, Parazzini F, Davoli E, Rabaiotti M, Restelli S, Stramare L, Dindelli M, La Vecchia C, Fanelli R. Validity of self-reported smoking habits in pregnancy: A saliva cotinine analysis. Acta Obstet Gynecol Scand 1996;75:352-4.Google Scholar
  32. 32.
    Lindqvist R, Lendahls L, Tollbom O, Aberg H, Hakansson A. Smoking during pregnancy: Comparison of self-report and cotinine levels in 496 women. Acta Obstet Gynecol Scand 2002;81:240-4.Google Scholar
  33. 33.
    Qwn L, McNeill A. Saliva cotinine as indicator of cigarette smoking in pregnant women. Addiction 2001;96:1001-6.Google Scholar
  34. 34.
    Lancaster T, Silagy C, Fowler G. Training health professionals in smoking cessation (Cochrane Review). The Cochrane Library. Oxford, Update Software, Issue 3, 2000.Google Scholar
  35. 35.
    Gilpin E, Pierce J, Johnson M, Bal D. Physician advice to quit smoking: Results from the 1990 California Tobacco Survey. J Gen Intern Med 1993;22:118-21.Google Scholar
  36. 36.
    Jones-Webb R, McKiver M, Pirie P, Miner K. Relationships between physician advice and tobacco and alcohol use during pregnancy. Am J Prev Med 1999;16:244-7.Google Scholar

Copyright information

© Plenum Publishing Corporation 2003

Authors and Affiliations

  • Monique Chaaya
    • 1
  • Johnny Awwad
    • 1
  • Oona M.R. Campbell
    • 2
  • Abla Sibai
    • 1
  • Afamia Kaddour
    • 1
  1. 1.Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
  2. 2.London School of Hygiene and Tropical MedicineUniversity of LondonLondonEngland

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