title: Families at risk: home and car smoking among pregnant women attending a low-income, urban prenatal clinic.
abstract: BACKGROUND
  Secondhand smoke exposure (SHSe) has been identified as a distinct risk factor for adverse obstetric and gynecological outcomes. This study examined the prevalence of SHSe reduction practices (i.e., home and car smoking bans) among pregnant women in a large U.S. prenatal clinic serving low-income women.
  
  
  METHODS
  Pregnant women (N = 820) attending a university-based, urban prenatal clinic in Houston, Texas, completed a prenatal questionnaire assessing bans on household and car smoking and a qualitative urine cotinine test as part of usual care. Data were collected from April 2011 to August 2012.
  
  
  RESULTS
  Nearly one-third (n = 257) of the sample reported at least 1 smoker living in the home. About a quarter of the women in the full sample did not have a total smoking ban in their home and car. Within smoking households, 44% of the pregnant women reported smoking, 56% reported smoking by another household member, and in 26% of smoking households both the pregnant woman and at least one other person were smoking. Only 43% of women with a household smoker reported a total ban on smoking, with higher rates among Hispanic women. Smoking bans were less common when the pregnant women smoked, when more than 1 smoker resided in the home, and when pregnant with her first child.
  
  
  CONCLUSIONS
  SHSe among low-income pregnant women is high, and interventions to raise awareness and increase the establishment of smoking bans in homes and cars are warranted.
authors.affiliation: Department of Family and Community Medicine, UT Health-University of Texas Medical School at Houston, Houston, TX; angela.l.stotts@uth.tmc.edu.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Stotts
authors.affiliation: Department of Family and Community Medicine, UT Health-University of Texas Medical School at Houston, Houston, TX;
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Northrup
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, UT Health-University of Texas Medical School at Houston, Houston, TX;
authors.forename: Maria S
authors.initials: MS
authors.lastname: Hutchinson
authors.affiliation: Department of Pediatrics, UT Health-University of Texas Medical School at Houston, Houston, TX.
authors.forename: Claudia
authors.initials: C
authors.lastname: Pedroza
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, UT Health-University of Texas Medical School at Houston, Houston, TX;
authors.forename: Sean C
authors.initials: SC
authors.lastname: Blackwell
mesh_terms: D000328:Adult; D001336:Automobiles; D002648:Child; D003367:Cotinine / Q000652:urine; D005191:Family Characteristics; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008430:Maternal-Child Health Centers; D011203:Poverty; D011247:Pregnancy; D011295:Prenatal Care; D015995:Prevalence; D012307:Risk Factors; D061845:Smoke-Free Policy; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014505:Urban Population; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution; D003367:Cotinine