Tobacco use and secondhand smoke exposure during pregnancy in two African countries: Zambia and the Democratic Republic of the Congo.
OBJECTIVE
To study pregnant women's knowledge, attitudes and behaviors towards tobacco use and secondhand smoke (SHS) exposure, and exposure to advertising for and against tobacco products in Zambia and the Democratic Republic of the Congo (DRC).


METHODS
Prospective cross-sectional survey between November 2004 and September 2005.


METHODS
Antenatal care clinics in Lusaka, Zambia, and Kinshasa, DRC.


METHODS
Pregnant women in Zambia (909) and the DRC (847).


METHODS
Research staff administered a structured questionnaire to pregnant women attending antenatal care clinics.


METHODS
Pregnant women's use of tobacco, exposure to SHS, knowledge of the harms of tobacco and exposure to advertising for and against tobacco products.


RESULTS
Only about 10% of pregnant women reported ever having tried cigarettes (6.6% Zambia; 14.1% DRC). However, in the DRC, 41.8% of pregnant women had tried other forms of tobacco, primarily snuff. About 10% of pregnant women and young children were frequently or always exposed to SHS. Pregnant women's knowledge of the hazards of smoking and SHS exposure was extremely limited. About 13% of pregnant women had seen or heard advertising for tobacco products in the last 30 days.


CONCLUSIONS
Tobacco use and SHS exposure pose serious threats to the health of women, infants and children. In many African countries, maternal and infant health outcomes are often poor and will likely worsen if maternal tobacco use increases. Our findings suggest that a 'window of opportunity' exists to prevent increased tobacco use and SHS exposure of pregnant women in Zambia and the DRC.
University of Zambia, Lusaka, Zambia.
Elwyn
E
Chomba
Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
Antoinette
A
Tshefu
Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
Marie
M
Onyamboko
University of Zambia, Lusaka, Zambia.
Christine
C
Kaseba-Sata
Research Triangle Institute, Research Triangle Park, North Carolina, USA.
Janet
J
Moore
Research Triangle Institute, Research Triangle Park, North Carolina, USA.
Elizabeth M
EM
McClure
National Institute of Child Health and Human Development, Rockville, Maryland, USA.
Nancy
N
Moss
Research Triangle Institute, Research Triangle Park, North Carolina, USA.
Norman
N
Goco
National Cancer Institute, Rockville, Maryland, USA.
Michele
M
Bloch
Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Robert L
RL
Goldenberg
D000328:Adult; D000329:Advertising; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018811:Maternal Exposure; D011247:Pregnancy; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D014030:Tobacco, Smokeless; D015024:Zambia / Q000453:epidemiology
D014028:Tobacco Smoke Pollution