Tobacco use and secondhand smoke exposure during pregnancy in low- and middle-income countries: the need for social and cultural research.
Tobacco use is a leading cause of death and of poor pregnancy outcome in many countries. While tobacco use is decreasing in many high-income countries, it is increasing in many low- and middle-income countries (LMICs), where by the year 2030, 80% of deaths caused by tobacco use are expected to occur. In many LMICs, few women smoke tobacco, but strong evidence indicates this is changing; increased tobacco smoking by pregnant women will worsen pregnancy outcomes, especially in resource-poor settings, and threatens to undermine or reverse hard-won gains in maternal and child health. To date, little research has focused on preventing pregnant women's tobacco use and secondhand smoke (SHS) exposure in LMICs. Research on social and cultural influences on pregnant women's tobacco use will greatly facilitate the design and implementation of effective prevention programs and policies, including the adaptation of successful strategies used in high-income countries. This paper describes pregnant women's tobacco use and SHS exposure and the social and cultural influences on pregnant women's tobacco exposure; it also presents a research agenda put forward by an international workgroup convened to make recommendations in this area.
Nichter
Mimi
M
University of Arizona, Tucson, Arizona.
Greaves
Lorraine
L
British Columbia Centre of Excellence for Women's Health, Vancouver, Canada.
Bloch
Michele
M
National Cancer Institute, Rockville, Maryland.
Paglia
Michael
M
Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Scarinci
Isabel
I
University of Alabama, Birmingham, Alabama.
Tolosa
Jorge E
JE
Global Network for Perinatal and Reproductive Health, Portland, Oregon.|Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon.
Novotny
Thomas E
TE
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon.|San Diego State University, San Diego, California.
D000383:Agriculture; D001942:Breast Feeding; D003469:Culture; D019049:Developed Countries; D003906:Developing Countries; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009040:Motion Pictures; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care; D012106:Research; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D000074606:Smoking Prevention; D012931:Social Environment; D013690:Television; D019460:Tobacco Industry; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000517:prevention & control*; D014030:Tobacco, Smokeless / Q000009:adverse effects
D014028:Tobacco Smoke Pollution