title: Ecological and individual predictors of maternal smoking behaviour. Looking beyond individual socioeconomic predictors at the community setting.
abstract: The aim of this study is to examine the prevalence of smoking during pregnancy by the individual mother's sociodemographic characteristics and ecological factors at the community level (suburbs). This analysis combined 1996 Australia Census and data on 3424 women attending Well-Baby-Clinics (WBC) between January 1996 and February 1998 within a region in South Western Sydney (SWS), Australia. The prevalence of maternal smoking was 31%. Maternal factors such as marital status, country of birth, education, occupation, socioeconomic status (SES), and types of antenatal care (ANC) were independent risk factors for maternal smoking. Small area analysis revealed suburbs within SWS with high rates of maternal smoking (47-57%). Community level characteristics such as low income, low educational level, young mothers, and unemployment can explain 85.7% of the variation in maternal smoking in SWS. Smoking during pregnancy is recognised as a serious risk factor to the unborn child. The present study draws attention to local community level factors, other than individual SES, which may be important when developing strategies for maternal smoking prevention programs.
authors.affiliation: Principal Research Fellow and Conjoint Lecturer, The Simpson Centre for Health Services Research, Liverpool Hospital, Locked Bag 7103, Liverpool, BC NSW 1871, Australia. hai.phung@swsahs.nsw.gov.au
authors.forename: Hai N
authors.initials: HN
authors.lastname: Phung
authors.forename: Adrian E
authors.initials: AE
authors.lastname: Bauman
authors.forename: Lis
authors.initials: L
authors.lastname: Young
authors.forename: Mai H
authors.initials: MH
authors.lastname: Tran
authors.forename: Ken M
authors.initials: KM
authors.lastname: Hillman
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008425:Maternal Behavior / Q000523:psychology*; D008875:Middle Aged; D009035:Mothers / Q000706:statistics & numerical data; D009517:New South Wales / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D017062:Small-Area Analysis; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D012959:Socioeconomic Factors