title: Factors associated with second-hand smoke exposure in non-smoking pregnant women in Spain: self-reported exposure and urinary cotinine levels.
abstract: The aim of this study was to evaluate the main sources of and sociodemographic factors associated with second-hand smoke (SHS) exposure, assessed both by questionnaire and by urinary cotinine (UC) levels, in non-smoking pregnant women. We conducted a cross-sectional study in pregnant women from 4 different regions in Spain. A total of 1783 non-smoking pregnant women completed a questionnaire about their previous smoking habit and SHS exposure in their 3rd trimester of pregnancy and provided a urine sample for measuring UC levels. We used logistic regression models to assess the relationship between several sociodemographic variables and some potential sources of SHS exposure. In addition, we analysed the association of several sociodemographic variables and the SHS exposure according to UC levels, using Tobit regression analysis. More than half of women (55.5%) were exposed to SHS in their 3rd trimester of pregnancy. The following variables were associated with SHS exposure: having smoked previously, low educational level, and being primiparous. Data collection after the first law banning smoking in public places was associated with lower risk of SHS exposure in restaurants and at work. UC levels were higher among women exposed to more than one source. Having a partner who smoked at home was the source of SHS with the greatest impact on UC levels, followed by having a partner who smoked but not at home, other people smoking in the household, being exposed during leisure time, at work and at restaurants. The most important source of SHS exposure was exposure at home. Prevention of SHS exposure should be addressed not only with pregnant women but also with their families.
authors.affiliation: Public Health Department, Basque Government, San Sebastian, Spain; University of the Basque Country (UPV/EHU), San Sebastian, Spain; Health Research Institute (BIODONOSTIA), San Sebastian, Spain. Electronic address: jj.aurreko@gmail.com.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Aurrekoetxea
authors.affiliation: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Center for Public Health Research (CSISP), Valencia, Spain. Electronic address: murcia_mar@gva.es.
authors.forename: Mario
authors.initials: M
authors.lastname: Murcia
authors.affiliation: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Center for Public Health Research (CSISP), Valencia, Spain. Electronic address: rebagliato_mar@gva.es.
authors.forename: Marisa
authors.initials: M
authors.lastname: Rebagliato
authors.affiliation: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of Oviedo, Oviedo, Spain. Electronic address: capua.uo@uniovi.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Fernández-Somoano
authors.affiliation: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Public Health Laboratory, Basque Government, Spain. Electronic address: ane_m2002@yahoo.es.
authors.forename: Ane Miren
authors.initials: AM
authors.lastname: Castilla
authors.affiliation: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Hospital del Mar Research Institute (IMIM), Barcelona, Spain; Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. Electronic address: mguxens@creal.cat.
authors.forename: Mònica
authors.initials: M
authors.lastname: Guxens
authors.affiliation: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Public Health Agency of Barcelona, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain. Electronic address: mjlopez@aspb.cat.
authors.forename: María José
authors.initials: MJ
authors.lastname: López
authors.affiliation: University of the Basque Country (UPV/EHU), San Sebastian, Spain; Health Research Institute (BIODONOSTIA), San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain. Electronic address: aitana.lertxundi@ehu.es.
authors.forename: Aitana
authors.initials: A
authors.lastname: Lertxundi
authors.affiliation: Public Health Laboratory, Basque Government, Spain. Electronic address: metabobi-san@ej-gv.es.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Espada
authors.affiliation: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of Oviedo, Oviedo, Spain. Electronic address: atardon@uniovi.es.
authors.forename: Adonina
authors.initials: A
authors.lastname: Tardón
authors.affiliation: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Center for Public Health Research (CSISP), Valencia, Spain; Department of Nursing, University of Valencia, Valencia, Spain. Electronic address: ballester_fer@gva.es.
authors.forename: Ferran
authors.initials: F
authors.lastname: Ballester
authors.affiliation: Public Health Department, Basque Government, San Sebastian, Spain; Health Research Institute (BIODONOSTIA), San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain. Electronic address: ambien4ss-san@ej-gv.es.
authors.forename: Loreto
authors.initials: L
authors.lastname: Santa-Marina
mesh_terms: D000328:Adult; D003367:Cotinine / Q000652:urine*; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000032:analysis* / Q000706:statistics & numerical data; D018811:Maternal Exposure / Q000706:statistics & numerical data*; D011247:Pregnancy; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000032:analysis* / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution; D003367:Cotinine
keywords: Biological monitoring; Cotinine; Passive smoking; Pregnant women; SHS