Abstract
Background
Recent data suggest that although smoking during pregnancy has declined in North America, this has more to do with falling rates of smoking initiation among women of childbearing age than with increased rates of pregnancy-related smoking cessation. One possible explanation is poor exposure to effective stop-smoking strategies. Better information about women who smoke during pregnancy may help target these interventions more effectively.
Methods
The study was a cross-sectional, self-administered survey of a consecutive sample of 916 (40.4% of eligible) women who delivered healthy babies in 1997–98 at a tertiary teaching hospital in Hamilton, Ontario. Our main focus was on health behaviours (smoking, drinking, eating, and exercise habits) before and during pregnancy; but we also included questions about the presence of (other) children and (other) smokers in the household, perceived health status, the subject’s age and level of education, and whether or not the present pregnancy was planned. Factors associated with pregnancy-related smoking cessation were identified using multiple logistic regression.
Results
Respondents were better educated and healthier, but smoked at rates similar to women of childbearing age in Hamilton at the time of the survey. Two thirds of prior smokers or 20% of respondents overall continued to smoke during pregnancy. After adjustment for other factors, three factors were associated with ongoing smoking during pregnancy: having other smokers in the household; having other children in the household; and not having post-secondary education.
Conclusions
Many pregnant smokers are not being reached by current stop-smoking strategies. New ways to help these women and their partners are needed.
Résumé
Contexte
Selon des données récentes, si le tabagisme durant la grossesse est en baisse en Amérique du Nord, c’est plutôt parce que moins de femmes en âge de procréer se mettent à fumer qu’en raison d’une augmentation des taux de renoncement au tabac durant la grossesse. Une explication possible serait la piètre exposition à des stratégies antitabac efficaces. Une meilleure information sur les femmes qui fument durant la grossesse pourrait contribuer à mieux cibler de telles mesures.
Méthode
Dans cette étude transversale, un échantillon consécutif de 916 femmes (40,4 % de la population admissible) ayant donné naissance à des bébés en santé en 1997–1998 dans un hôpital d’enseignement de soins tertiaires à Hamilton (Ontario) a rempli un questionnaire d’auto-évaluation portant principalement sur les comportements liés à la santé (tabagisme, consommation d’alcool, alimentation et exercice) avant et durant la grossesse, mais comportant aussi des questions sur la présence d’(autres) enfants et d’(autres) fumeurs dans le ménage, sur l’état de santé subjectif, sur l’âge et le niveau d’instruction du sujet et sur le fait que la grossesse en cours ait été planifiée ou non. Les facteurs associés au renoncement au tabac durant la grossesse ont été cernés par régression logistique multiple.
Résultats
Les répondantes étaient mieux instruites et en meilleure santé que l’ensemble des femmes en âge de procréer vivant à Hamilton au moment de l’enquête, mais leurs taux de tabagisme étaient semblables. Les deux tiers des anciennes fumeuses (20 % de l’ensemble des répondantes) ont continué à fumer durant leur grossesse. Après rajustement selon d’autres facteurs, nous avons relevé trois facteurs associés au maintien du tabagisme durant la grossesse: la présence d’autres fumeurs dans le ménage; la présence d’autres enfants dans le ménage; et l’arrêt des études après le secondaire.
Conclusion
De nombreuses fumeuses enceintes ne sont pas touchées par les stratégies antitabac actuelles. Il faudrait trouver de nouvelles façons d’aider ces femmes et leurs partenaires.
References
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