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Delcroix MH, Delcroix-Gomez C, Marquet P, Gauthier T, Thomas D, Aubard Y. Active or passive maternal smoking increases the risk of low birth weight or preterm delivery: Benefits of cessation and tobacco control policies. Tob Induc Dis 2023; 21:72. [PMID: 37256119 PMCID: PMC10226447 DOI: 10.18332/tid/156854] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/07/2022] [Accepted: 11/23/2022] [Indexed: 06/01/2023] Open
Abstract
In France, maternal smoking, active or passive, remains one of the highest in Europe. At the same time, there is an increase in the number of low birth weight (<2500 g) and premature (<37 weeks of amenorrhea) newborns. The objective of this narrative review is to examine the impact of active or passive maternal smoking on birth weight or prematurity rates, and to consider the benefits of policies to stop or control smoking. This is a narrative review that analyzes and discusses the major articles published over the past 20 years regarding the role of active or passive maternal smoking on the risk of low birth weight or preterm delivery. Articles were selected using the following keywords: maternal smoking, low birth weight, preterm birth, smoking cessation, passive smoking, exhaled carbon monoxide, tobacco control policies. Active smoking is associated, in a dose-response relationship, with increased risks of low birth weight and preterm delivery. Passive smoking, mainly related to the presence of a smoking spouse, increases the risk of low birth weight and preterm birth. Our review confirmed also the benefits of smoking cessation, even in the third trimester, in reducing the risk of small for gestation age or fetal growth restriction and preterm birth. Several studies of tobacco control policies have been shown to be effective in significantly reducing maternal smoking. There is sufficient evidence to infer a causal link between active or passive maternal smoking and low birth weight or preterm delivery. This causal link is compelling and sufficient to justify intensifying efforts to promote rapid progress in tobacco control policies, with the vision of a tobacco-free generation, and smoking cessation with best practices during preconception or pregnancy.
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Affiliation(s)
- Michel-Henri Delcroix
- Établissement Public de Santé Mentale, Association Périnatalité Recherche Information - Maternité Sans Tabac, Bailleul, France
| | - Conchita Delcroix-Gomez
- Service de Gynécologie-Obstétrique, Pôle Femme-Enfant, Centre Hospitalier d’Arras, Arras, France
| | - Pierre Marquet
- Service de Pharmacologie, Toxicologie et de Pharmacovigilance, Centre Hospitalier Universitaire, Limoges, France
| | - Tristan Gauthier
- Service de Gynécologie-Obstétrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire, Limoges, France
| | - Daniel Thomas
- Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | - Yves Aubard
- Service de Gynécologie-Obstétrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire, Limoges, France
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2
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Pereira B, Figueiredo B, Miguel Pinto T, Míguez MC. Tobacco consumption from the 1st trimester of pregnancy to 7 months postpartum: Effects of previous tobacco consumption, and depression and anxiety symptoms. Addict Behav 2022; 124:107090. [PMID: 34464914 DOI: 10.1016/j.addbeh.2021.107090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/31/2021] [Accepted: 08/18/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Previous tobacco consumption, and depression and anxiety symptoms are major predictors of women's tobacco consumption during pregnancy and the postpartum period. However, the joint effect of these predictors is still unexplored. This study aimed to analyse the effects of previous tobacco consumption, and depression and anxiety symptoms on women's tobacco consumption status and quantity from the 1st trimester of pregnancy to 7 months postpartum. METHOD A sample of 803 Spanish women was assessed at the 1st and the 3rd trimester of pregnancy, and at 2 and 7 months postpartum. Previous tobacco consumption, and depression and anxiety symptoms were self-reported. Pregnancy and postpartum tobacco consumption were confirmed with biochemical tests. RESULTS Women with more previous tobacco consumption or more anxiety symptoms presented a steeper decrease in the number of cigarettes smoked per week from the 1st trimester of pregnancy to the childbirth, although smoking more cigarettes than women with less previous tobacco consumption or less anxiety symptoms. Women with more depression symptoms showed a higher tendency to relapse smoking during the first 2 months postpartum. CONCLUSIONS Previous tobacco consumption and anxiety symptoms were associated with higher smoking quantity during pregnancy, while depression symptoms were associated with consumption relapse during postpartum period.
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Affiliation(s)
- Beatriz Pereira
- University of Santiago de Compostela, Faculty of Psychology, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain
| | - Bárbara Figueiredo
- University of Minho, School of Psychology, Campus de Gualtar, Braga, Portugal
| | - Tiago Miguel Pinto
- University of Minho, School of Psychology, Campus de Gualtar, Braga, Portugal
| | - M Carmen Míguez
- University of Santiago de Compostela, Faculty of Psychology, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain.
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3
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Pike CK, Sofis MJ, Budney AJ. Correlates of continued cannabis use during pregnancy. Drug Alcohol Depend 2021; 227:108939. [PMID: 34358772 PMCID: PMC8464496 DOI: 10.1016/j.drugalcdep.2021.108939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cannabis use is increasingly common among pregnant women despite concern that it may be linked to adverse maternal and infant outcomes. Determining whether variables associated with cannabis use predict whether women continue or quit using during pregnancy may inform strategies to reduce prenatal use. METHODS Pregnant women who regularly used cannabis before pregnancy (n = 296) were recruited via Facebook. After finding out they were pregnant, 41 % reported quitting, 13 % quit then relapsed, 32 % reduced use, and 15 % continued use at the same rate. Differences among these four cannabis use status groups (quit, relapsed, reduced, continued) in sociodemographics, cannabis use, cigarette use, perceived risk/benefit, delay discounting, and communications about cannabis with their doctor were assessed. RESULTS Compared to those who quit, continuing use during pregnancy was associated with being unemployed (Relative Risk (RR) = .32, 95 %CI [.13, .78]), using cigarettes pre-pregnancy (RR = 3.43, 95 %CI [1.32, 8.94]), being in an earlier trimester (RR = 4.38, 95 %CI [1.18, 16.23]), less perceived risk (RR = .79, 95 %CI [.74, .85]), and more days per week of use pre-pregnancy (RR = .10, 95 %CI [.01, .84]). Unintended pregnancy, shorter time to cannabis use after waking pre-pregnancy, using cannabis more times per day pre-pregnancy, and greater perceived benefits of use had significant bivariate associations with continued use during pregnancy, but did not retain significance in a multinomial model. CONCLUSIONS Identification of these correlates provides potential targets for prevention of or intervention for prenatal cannabis use. However, much more research is needed to understand prenatal cannabis use and its effects in order to better educate women and healthcare providers, and to design optimal public health strategies.
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Affiliation(s)
- Chelsea K Pike
- Geisel School of Medicine, Dartmouth College, Center for Technology and Behavioral Health, 46 Centerra Parkway, Suite 315, Lebanon, NH, USA.
| | - Michael J Sofis
- Advocates for Human Potential, Inc., Corporate Office, 490-B Boston Post Road, Sudbury, MA, USA.
| | - Alan J Budney
- Geisel School of Medicine, Dartmouth College, Center for Technology and Behavioral Health, 46 Centerra Parkway, Suite 315, Lebanon, NH, USA.
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Míguez MC, Pereira B. Effects of active and/or passive smoking during pregnancy and the postpartum period. An Pediatr (Barc) 2021; 95:222-232. [PMID: 34556446 DOI: 10.1016/j.anpede.2020.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 07/28/2020] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Tobacco smoking may cause adverse effects during pregnancy and postpartum. The aim of this study was to evaluate several repercussions of active and/or passive smoking by the mother at home, during pregnancy, at delivery, as well as for the newborn baby and breastfeeding, including the effect of quitting smoking in the first trimester of pregnancy. METHODS A prospective longitudinal study was carried out with a sample of 800 pregnant women. Four evaluations were made: first and third trimester of pregnancy, and 2 and 6/8 months postpartum. Sociodemographic, obstetric, health and tobacco consumption details were collected, with biochemical tests being performed to confirm the self-reported abstinence. RESULTS Being an active and passive smoker predicted suffering complications in pregnancy (OR 2.50; 95% CI; 1.42-4.35) and delivery (OR 3.10; 95% CI; 1.75-5.51), and also tended not to breastfeed (OR 2.44; 95% CI; 1.35-4.42). Being an active smoker predicted complications at childbirth (OR 5.58; 95% CI; 2.64-7.77), for the baby (OR 3.77; 95% CI; 1.53-9.36) and not breastfeeding at 2 (OR 25.73; 95% CI; 11.95-55.40), and 6/8 months postpartum (OR 6.61; 95% CI; 3.21-13.58). Being a passive smoker reduces the intend to breastfeed (OR 1.81; 95% CI; 1.11-2.95), and the practice of breastfeeding at 2 months postpartum (OR 1.94; 95% CI; 1.11-3.37). Women who quit smoking are less likely to suffer complications in pregnancy and childbirth, and are more likely to attend antenatal and breastfeeding classes, and to have babies with higher birth weight. CONCLUSIONS Active and passive tobacco consumption has significant implications during pregnancy and postpartum period. Smoking cessation at the beginning of pregnancy reverses much of these effects.
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Affiliation(s)
- M Carmen Míguez
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
| | - Beatriz Pereira
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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Fujita ÂTL, Rodrigues-Junior AL, Gomes NC, Martinis BSD, Baddini-Martinez JA. Socio-demographic and psychological features associated with smoking in pregnancy. J Bras Pneumol 2021; 47:e20210050. [PMID: 34495137 PMCID: PMC8642815 DOI: 10.36416/1806-3756/e20210050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/31/2021] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate how social and psychological characteristics differ between pregnant women who smoke and do not smoke. To explore associations between social and psychological features with changes of smoking habits by the end of pregnancy. Methods A case-control study was set up. Smokers cases were never-smokers and ex-smokers controls. Pregnant women (n=328) from public prenatal services were interviewed. Socio-demographic data and psychological variables – personality traits, anxiety, depression, perceived stress, maternal fetal-attachment - were measured. Saliva samples were collected to measure cotinine and to check self-informed smoking status. In addition, 66 smokers were also assessed regarding smoking habits by late pregnancy. Smoking status was defined as a dependent variable. Exposure factors were analyzed through odds ratios. Logistic models and contingency tables were employed according to the nature of variables. “Qualitative change in smoking” was defined as a dependent variable for the last evaluation, and a logistic regression model was built. Results Lower schooling, higher age, use of alcohol and drugs, living without a partner, and passive smoking showed associations with smoking. Anxiety, depression and perceived stress also exhibited positive association with smoking. Among personality traits, only Neuroticism was associated with smoking. None of the variables were associated with qualitative change in smoking by the end of pregnancy. Conclusion Smoking during pregnancy is associated with more unfavorable social conditions. Pregnant women who smoke exhibit more negative psychological states than nonsmokers, including a profile of accentuated Neuroticism. None of the investigated variables could predict changes in smoking during pregnancy.
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Affiliation(s)
- Ângela Tamye Lopes Fujita
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP) Brasil
| | - Antonio Luiz Rodrigues-Junior
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP) Brasil
| | - Nayna Cândida Gomes
- Departamento de Química, Faculdade de Filosofia, Ciência e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP) Brasil
| | - Bruno Spinosa de Martinis
- Departamento de Química, Faculdade de Filosofia, Ciência e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP) Brasil
| | - José Antonio Baddini-Martinez
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP) Brasil.,Disciplina de Pneumologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo (SP) Brasil
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6
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Dias CC, Figueiredo B. Unidirectional and bidirectional links between maternal depression symptoms and infant sleep problems. J Sleep Res 2021; 30:e13363. [PMID: 33900005 DOI: 10.1111/jsr.13363] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/16/2021] [Accepted: 04/01/2021] [Indexed: 01/23/2023]
Abstract
The present study explored (a) the unidirectional and bidirectional links between maternal depression symptoms and infant sleep problems and (b) the moderating role of the infant's sex on these unidirectional and bidirectional links. Mothers (N = 312) completed measures of depression symptoms at the third pregnancy trimester, and measures of depression symptoms and infant sleep problems at 2 weeks, and at 3 and 6 months postpartum. The findings revealed: (a) a main unidirectional link between maternal depression symptoms during the third trimester and infant sleep problems, particularly on infant unsettled sleep and daytime sleepiness at 3 and 6 months; (b) bidirectional links between maternal postpartum depression symptoms and infant unsettled sleep at 2 weeks, 3 and 6 months of life; and (c) the reported links between maternal depression symptoms and infant sleep problems occur specifically in boys and their mothers. Maternal prenatal depression symptoms are linked to infant sleep problems and infant sleep problems are linked to maternal postnatal depression symptoms. Boys are more susceptible to the effects of maternal prenatal and postnatal depression symptoms, and mothers of boys are more susceptible to the effects of boys' sleep problems.
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Factors Associated with Smoking Relapse in the Early Postpartum Period: A Prospective Longitudinal Study in Spain. Matern Child Health J 2020; 25:998-1006. [DOI: 10.1007/s10995-020-03019-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
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Effects of Tobacco Consumption and Anxiety or Depression during Pregnancy on Maternal and Neonatal Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218138. [PMID: 33158085 PMCID: PMC7663341 DOI: 10.3390/ijerph17218138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 11/24/2022]
Abstract
This study analyzed the possible interaction effects between tobacco consumption and anxiety or depression during pregnancy on maternal and neonatal health. We recruited a sample of 807 pregnant Spanish women from public healthcare services. Women completed a questionnaire on sociodemographic variables, health status and tobacco consumption (continuous, quitting or no consumption) in the first and third trimester of pregnancy and at 2 months postpartum, and self-reported measures of anxiety and depression in the first trimester. Abstinence of tobacco consumption was verified through biochemical measurements. Interaction effects between tobacco consumption and anxiety were found for delivery (p < 0.001), neonatal health complications (p = 0.026) and gestational age at birth (p = 0.029). Interaction effects between tobacco consumption and depression were found for pregnancy (p = 0.032), delivery complications (p < 0.001) and weeks of gestation at birth (p = 0.031). This study suggests that there are different kinds of interaction effects between tobacco consumption and anxiety or depression. Smokers with high anxiety presented more delivery complications compared to quitters and non-smokers with high anxiety. There is a cumulative effect of anxiety on the effects of tobacco consumption on maternal health. The results highlighted the beneficial impact of quitting smoking during pregnancy to reduce the risk of suffering anxiety, depression and health complications.
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9
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Míguez MC, Pereira B. [Effects of active and/or passive smoking during pregnancy and the postpartum period]. An Pediatr (Barc) 2020; 95:S1695-4033(20)30288-5. [PMID: 33041241 DOI: 10.1016/j.anpedi.2020.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/11/2020] [Accepted: 07/28/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Tobacco smoking may cause adverse effects during pregnancy and postpartum. The aim of this study was to evaluate several repercussions of active and/or passive smoking by the mother at home, during pregnancy, at delivery, as well as for the new born baby and breastfeeding, including the effect of quitting smoking in the first trimester of pregnancy. METHODS A prospective longitudinal study was carried out with a sample of 800 pregnant women. Four evaluations were made: first and third trimester of pregnancy, and 2 and 6/8 months postpartum. Sociodemographic, obstetric, health and tobacco consumption information was collected, with biochemical tests being performed to confirm the self-reported abstinence. RESULTS Being an active and passive smoker predicted suffering complications in pregnancy (OR 2.50; 95% CI; 1.42-4.35) and delivery (OR 3.10; 95% CI; 1.75-5.51), and also intend not to breastfeed (OR 2.44; 95% CI; 1.35-4.42). Being an active smoker predicted complications at childbirth (OR 5.58; 95% CI; 2.64-7.77), for the baby (OR 3.77; 95% CI; 1.53-9.36) and not breastfeeding at 2 (OR 25.73; 95% CI; 11.95-55.40), and 6/8 months postpartum (OR 6.61; 95% CI; 3.21-13.58). Being a passive smoker reduces the intention to breastfeed (OR 1.81; 95% CI; 1.11-2.95), and the practice of breastfeeding at 2 months postpartum (OR 1.94; 95% CI; 1.11-3.37). Women who quit smoking are less likely to suffer complications in pregnancy and childbirth, and are more likely to attend antenatal and breastfeeding classes, and to have babies with higher birth weight. CONCLUSIONS Active and passive tobacco consumption has significant implications during pregnancy and postpartum period. Smoking cessation at the beginning of pregnancy reverses much of these effects.
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Affiliation(s)
- M Carmen Míguez
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, España.
| | - Beatriz Pereira
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, España
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10
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The importance of socioeconomic position in smoking, cessation and environmental tobacco smoke exposure during pregnancy. Sci Rep 2020; 10:15584. [PMID: 32973155 PMCID: PMC7515871 DOI: 10.1038/s41598-020-72298-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/24/2020] [Indexed: 01/11/2023] Open
Abstract
Tobacco is still a leading cause of premature death and morbidity. Particular attention has been given to pregnant women due to the scientific evidence on the importance of early life exposures for disease onset later in life. The purpose of this study was to assess smoking prevalence, smoking cessation rate and environmental tobacco smoke (ETS) exposure, and the role of socioeconomic position (SEP) on these behaviors among pregnant women. Cross-sectional data of 619 pregnant women, aged between 18 and 46 years, from Porto Metropolitan Area, Portugal, on current smoking, ETS exposure and SEP indicators was collected, face-to-face, using a questionnaire filled in during a personal interview at the postpartum hospital stay. The smoking prevalence, and ETS exposure among non-smokers before pregnancy was 27.6% and 57.4%, respectively. 4.1% of the participants reported to have stopped smoking before pregnancy, whereas about 41% quitted along pregnancy, resulting in a smoking prevalence at birth of 14.6%. Exposure to ETS also decreased throughout pregnancy to 49.8% at birth. Lower educational level was significantly associated with both higher smoking prevalence and exposure to ETS and lower smoking cessation. This study demonstrates that smoking and ETS exposure during pregnancy remains high, and that there are still significant socioeconomic inequalities in smoking; thus tobacco-focused preventive interventions need to be reinforced.
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11
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Lisboa TP, Mimura AMS, da Silva JCJ, de Sousa RA. Chromium Levels in Tobacco, Filter and Ash of Illicit Brands Cigarettes Marketed in Brazil. J Anal Toxicol 2020; 44:514-520. [PMID: 31984423 DOI: 10.1093/jat/bkz106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 09/24/2019] [Accepted: 10/06/2019] [Indexed: 01/02/2023] Open
Abstract
Smoking is a public health problem and an important source of exposure to toxic metals. This work describes an efficient analytical method comparable to the ones based on atomic emission techniques for the determination of chromium in different constituent parts of cigarette samples (tobacco, filters and ashes) using electrothermal vaporization-atomic absorption spectrometry. The method was evaluated using 12 samples, and the results showed recovery values between 83 and 107%. The accuracy was also evaluated using a reference sample of tomato leaves (NIST SRM 1573a), which proved the efficiency of the method. The limits of detection of the developed method were 20.4, 75.8 and 80.7 ng g-1 for tobacco, filter and cigarette ash samples, respectively. The average chromium values found for the analyzed samples were in the range of 0.96 to 3.85 and from 0.32 to 0.80 μg/cigarette for tobacco and ashes, respectively. For most pre-burn and post-burn filter samples, the values of chromium concentration remained below limits of detection. The developed method presented adequate results about precision and accuracy, demonstrating its applicability in the determination of chromium in cigarette samples.
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Affiliation(s)
- Thalles Pedrosa Lisboa
- Grupo Baccan de Química Analítica, Departamento de Química, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Aparecida Maria Simões Mimura
- Colegiado de Licenciatura em Química, Universidade Federal do Vale do São Francisco, Campus Serra da Capivara, São Raimundo Nonato, PI, Brazil
| | - Julio Cesar Jose da Silva
- Grupo Baccan de Química Analítica, Departamento de Química, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Rafael Arromba de Sousa
- Grupo Baccan de Química Analítica, Departamento de Química, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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Kreyberg I, Bains KES, Carlsen KH, Granum B, Gudmundsdóttir HK, Haugen G, Hedlin G, Hilde K, Jonassen CM, Nordhagen LS, Nordlund B, Sjøborg KD, Skjerven HO, Staff AC, Söderhäll C, Vettukatil RM, Lødrup Carlsen KC. Stopping when knowing: use of snus and nicotine during pregnancy in Scandinavia. ERJ Open Res 2019; 5:00197-2018. [PMID: 30972353 PMCID: PMC6452060 DOI: 10.1183/23120541.00197-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 12/26/2018] [Indexed: 12/02/2022] Open
Abstract
The risk of adverse health effects in offspring due to maternal tobacco smoking during pregnancy is well documented [1], including epigenetic changes persisting in the offspring after prenatal exposure [2]. The effects of fetal exposure to nicotine from non-combustible tobacco products, such as snus or nicotine-replacement therapies (NRTs), are less clear. Use of snus leads to systemic absorption of nicotine into the maternal circulatory system, with subsequent exposure of the foetus through the placenta [3]. In young women, the use of snus increases in parallel with decreasing smoking rates but the use in pregnancy is unclear. Our aims were to determine the prevalence of snus use, smoking and other nicotine-containing product use during pregnancy, and to identify predictors for snus use in pregnancy. Prevalence was determined for 2528 women in Norway and Sweden based on the Preventing Atopic Dermatitis and ALLergies (PreventADALL) study, a population-based, mother–child birth cohort. Electronic questionnaires were completed in pregnancy week 18 and/or week 34, and potential predictors of snus use were analysed using logistic regression models. Ever use of any snus, tobacco or nicotine-containing products was reported by 35.7% of women, with similar rates of snus use (22.5%) and smoking (22.6%). Overall, 11.3% of women reported any use of nicotine-containing products in pregnancy up to 34 weeks, most often snus alone (6.5%). Most women (87.2%) stopped using snus by week 6 of pregnancy. Snus use in pregnancy was inversely associated with age and positively associated with urban living and personal or maternal history of smoking. While 11.3% of women used snus or other nicotine-containing products at some time, most stopped when recognising their pregnancy. Younger, urban living, previously smoking women were more likely to use snus in pregnancy. Of the 11.3% of women using any nicotine products in pregnancy (most often snus (6.5%)), the majority stop within pregnancy week 6. Snus use is associated with urban living, previous smoking, in utero smoking exposure of the index woman and lower age.http://ow.ly/Gyg230nmxIo
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Affiliation(s)
- Ina Kreyberg
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karen E S Bains
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kai-H Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Dept of Toxicology and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway
| | - Hrefna K Gudmundsdóttir
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Katarina Hilde
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Christine M Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.,Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Live S Nordhagen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,VID Specialized University, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Dept of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Katrine D Sjøborg
- Dept of Obstetrics and Gynaecology, Østfold Hospital Trust, Kalnes, Norway
| | - Håvard O Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne C Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Dept of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Riyas M Vettukatil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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Fillo J, Kamper-DeMarco KE, Brown WC, Stasiewicz PR, Bradizza CM. Emotion regulation difficulties and social control correlates of smoking among pregnant women trying to quit. Addict Behav 2019; 89:104-112. [PMID: 30286396 DOI: 10.1016/j.addbeh.2018.09.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/14/2018] [Accepted: 09/25/2018] [Indexed: 01/21/2023]
Abstract
Approximately 15% of US women currently smoke during pregnancy. An important step toward providing effective smoking cessation interventions during pregnancy is to identify individuals who are more likely to encounter difficulty quitting. Pregnant smokers frequently report smoking in response to intrapersonal factors (e.g., negative emotions), but successful cessation attempts can also be influenced by interpersonal factors (i.e., influence from close others). This study examined the association between emotion regulation difficulties, positive and negative social control (e.g., encouragement, criticism), and smoking cessation-related variables (i.e., smoking quantity, withdrawal symptoms) among pregnant smokers. Data were drawn from the pretreatment wave of a smoking cessation trial enrolling low-income pregnant women who self-reported smoking in response to negative affect (N = 73). Greater emotion regulation difficulties were related to greater smoking urges (b = 0.295, p = .042) and withdrawal symptoms (b = 0.085, p = .003). Additionally, more negative social control from close others was related to fewer smoking days (b = -0.614, p = .042) and higher smoking abstinence self-efficacy (b = 0.017, p = .002). More positive social control from close others interacted with negative affect smoking (b = -0.052, p = .043); the association between negative affect smoking and nicotine dependence (b = 0.812, p < .001) only occurred at low levels of positive social control. Findings suggest that emotion regulation difficulties may contribute to smoking during pregnancy by exacerbating women's negative experiences related to smoking cessation attempts. Negative social control was related to lower smoking frequency and greater confidence in quitting smoking, suggesting that it may assist pregnant smokers' cessation efforts. Positive social control buffered women from the effects of negative affect smoking on nicotine dependence. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01163864.
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Rozman T, Mivšek PA, Došler AJ, Kusterle M. A survey of women who continue to smoke during pregnancy in Slovenia. Eur J Midwifery 2018; 2:12. [PMID: 33537573 PMCID: PMC7848596 DOI: 10.18332/ejm/95283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/31/2018] [Accepted: 09/20/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Smoking in pregnancy is unhealthy and can also have negative effects on the foetus. However, there are still some women who do not quit smoking during pregnancy. The aim of the study was to identify Slovenian women at risk who smoke during pregnancy. METHODS A quantative approach using an online survey was adopted. The study was conducted in May and June 2017, in Slovenia. A snowball sample was used. Participation in the survey was anonymous and voluntary, and 118 women who identified themselves as smokers participated in the study. Descriptive statistics was used to analyse the data. RESULTS More than half (66%) did not quit smoking during pregnancy. Women who continued to smoke during pregnancy were usually younger, less educated with a partner who smoked. Women who smoked more cigarettes per day before conception were less likely to refrain from smoking during pregnancy. The most common reason for not quitting smoking during pregnancy was failure in attempts to quit (37%). CONCLUSIONS Women who smoke need support to stop smoking before pregnancy or, at least, in the first trimester. Special groups for smoking cessation need to be created. Further and more extensive research is warranted in Slovenia to assess this issue.
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Affiliation(s)
- Tjaša Rozman
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Polona A Mivšek
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | | | - Mateja Kusterle
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
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Román-Gálvez RM, Amezcua-Prieto C, Olmedo-Requena R, Lewis-Mikhael Saad AM, Martínez-Galiano JM, Bueno-Cavanillas A. Authors' reply re: Partner smoking infl uences whether mothers quit smoking during pregnancy: a prospective cohort study. BJOG 2017; 125:905. [PMID: 29243412 DOI: 10.1111/1471-0528.15031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2017] [Indexed: 11/28/2022]
Affiliation(s)
- R M Román-Gálvez
- Andalusian Health Service, Unidad de Gestión Clínica Churriana de la Vega, Granada, Spain.,Doctoral Program of Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | - C Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - R Olmedo-Requena
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - A M Lewis-Mikhael Saad
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - J M Martínez-Galiano
- CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.,University of Jaen, Jaén, Spain
| | - A Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
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Román-Gálvez RM, Amezcua-Prieto C, Olmedo-Requena R, Lewis-Mikhael Saad AM, Martínez-Galiano JM, Bueno-Cavanillas A. Partner smoking influences whether mothers quit smoking during pregnancy: a prospective cohort study. BJOG 2017; 125:820-827. [PMID: 29052334 DOI: 10.1111/1471-0528.14986] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To analyse the prevalence and intensity of smoking among pregnant women and their partners, and factors associated with quitting smoking among pregnant women. DESIGN A prospective cohort study, starting in 2013. SETTING Andalusia, the south of Spain. SAMPLE A cohort of 486 healthy pregnant women followed-up on three occasions during pregnancy. METHODS Estimation of the proportions of women and partners who quit smoking at each trimester. MAIN OUTCOME MEASURES To determine factors associated in a multivariable model, considering sociodemographic, obstetric, anthropometric, lifestyle variables, and the smoking habits of their partners. RESULTS A high proportion of women quit smoking during pregnancy (61.08%; 95% confidence interval, 95% CI 53.61-68.55%). The smoking rate amongst mothers decreased from 36.06% (n = 167) before pregnancy to 14.08% (n = 65), 12.39% (n = 54), and 11.92% (n = 51) during the three pregnancy trimesters (P < 0.001), and consumption decreased from 8.71 cigarettes/day in the first trimester to 5.51 cigarettes/day in the second trimester (P < 0.001) and 5.96 cigarettes/day in third trimester (P = 0.0002 first versus third trimester). There was only a minimal decrease in the frequency of smoking among the partners, however: 38.44% (n = 178) before pregnancy, and 36.07% (n = 167), 32.72% (n = 143), and 31.85% (n = 136) during the three trimesters of pregnancy. The consumption of cigarettes did not decrease among partners: 11.75, 11.67, and 12.09 cigarettes/day (P = 0.4299 first versus second trimester; P = 0.654 first versus third trimester). Women whose partner smoked were less likely to quit (adjusted odds ratio, aOR 0.26; 95% CI 0.12-0.55). CONCLUSIONS About one in ten pregnant women smoked and one in four was a passive smoker. Strategies to reduce tobacco exposure in pregnancy should include a focus on partner smoking. TWEETABLE ABSTRACT Pregnant women quit smoking cigarettes in pregnancy. What about their partners?
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Affiliation(s)
- R M Román-Gálvez
- Unidad de Gestión Clínica Churriana de la Vega, Andalusian Health Service, Churriana de la Vega, Granada, Spain.,Doctoral Program of Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | - C Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - R Olmedo-Requena
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - A M Lewis-Mikhael Saad
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - J M Martínez-Galiano
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.,University of Jaén, Jaén, Spain
| | - A Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
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