title: Ethnic differences in tobacco use during pregnancy: findings from a primary care sample in São Paulo, Brazil.
abstract: OBJECTIVE
  Tobacco use during pregnancy is a global health concern. To date the majority of research originates in developed countries, thus we have a need to better understand factors related to maternal health in developing countries. We examine the prevalence and correlates of smoking by ethnicity in a sample of pregnant primary care patients in São Paulo, Brazil.
  
  
  METHODS
  Data were obtained from completed surveys during perinatal care visits in primary care clinics. We examine a sample of 811 pregnant women surveyed during 20-30 weeks of pregnancy. Multiple logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (95% CI).
  
  
  RESULTS
  We found significant ethnic differences in smoking during pregnancy. Compared to White women, Black women were more likely to use tobacco during pregnancy (OR: 1.95; 95% CI: 1.16-3.27). In the fully adjusted model, when accounting for common mental disorders, differences in smoking during pregnancy by ethnicity remained (OR: 1.96; 95% CI: 1.14-3.36).
  
  
  CONCLUSIONS
  There are ethnic differences in tobacco use during pregnancy. Clinical implications including universal screening for tobacco use during pregnancy and culturally relevant approaches to smoking cessation are suggested.
authors.affiliation: a School of Social Work , University of Illinois , Urbana , IL , USA.
authors.forename: Karen Margaret
authors.initials: KM
authors.lastname: Tabb
authors.forename: Hsiang
authors.initials: H
authors.lastname: Huang
authors.forename: Paulo Rossi
authors.initials: PR
authors.lastname: Menezes
authors.forename: Gulnar
authors.initials: G
authors.lastname: Azevedo e Silva
authors.forename: Ya-Fen
authors.initials: YF
authors.lastname: Chan
authors.forename: Alexandre
authors.initials: A
authors.lastname: Faisal-Cury
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000208:ethnology; D011295:Prenatal Care; D015995:Prevalence; D011320:Primary Health Care; D017150:Public Sector; D012907:Smoking / Q000453:epidemiology / Q000208:ethnology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Brazil; common mental disorders; disparity; pregnancy; skin colour; smoking; tobacco use
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