title: Smoking during pregnancy and postpartum among Tunisian women.
abstract: OBJECTIVE
  The validity of self-reported smoking in population surveys remains an important question yet to be answered. This has been of particular concern in a situation where there is a strong social pressure against pregnant and postpartum women. An associated question is what would be the value of measuring urinary cotinine concentrations in such surveys to obtain validated smoking data.
  
  
  METHODS
  Cross-sectional analysis of data on self-reported smoking and urinary cotinine among a sample of 398 pregnant women and recently pregnant, mothers of infants under the age of 2 months, who came to the Family Planning Clinic in Tunis urban area for either prenatal or newborn care. We used quantitative colorimetric urine test based on the könig reaction, in which pink-red chromophores formed from nicotine and its metabolites condensation with barbituric acid were extracted into acetate buffer.
  
  
  RESULTS
  The smoking prevalence among Tunisian pregnant women or mothers of newborn infants was 4%. The validity of self-reported daily smoking was relatively low. Among women reporting no smoking at the interview 16% misreported active smoking. According to urinary cotinine values, the smoking prevalence was 18.8%.
  
  
  CONCLUSIONS
  These results substantiate the unreliability of self-report on smoking status among women in prenatal and postnatal period and have implications in clinical and education practice.
authors.affiliation: National Institute of Public Health, Tobacco Control Research Unity, Tunis, Tunisia. fradhouane@yahoo.fr
authors.forename: Radhouane
authors.initials: R
authors.lastname: Fakhfakh
authors.forename: Manel
authors.initials: M
authors.lastname: Jellouli
authors.forename: Anis
authors.initials: A
authors.lastname: Klouz
authors.forename: Majid
authors.initials: M
authors.lastname: Ben Hamida
authors.forename: Mohamed
authors.initials: M
authors.lastname: Lakhal
authors.forename: Chalbi
authors.initials: C
authors.lastname: Belkahia
authors.forename: Noureddine
authors.initials: N
authors.lastname: Achour
mesh_terms: D003124:Colorimetry; D003367:Cotinine / Q000032:analysis / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D049590:Postpartum Period / Q000502:physiology / Q000652:urine; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000652:urine; D037841:Pregnant People; D015995:Prevalence; D057566:Self Report; D012907:Smoking / Q000453:epidemiology* / Q000652:urine; D014416:Tunisia / Q000453:epidemiology; D016482:Urinalysis / Q000379:methods; D054928:Validation Studies as Topic
chemical_list: D003367:Cotinine