title: Preventing smoking during pregnancy: the importance of maternal knowledge of the health hazards and of the treatment options available.
abstract: OBJECTIVE
  To examine the pattern of tobacco use and knowledge about tobacco-related diseases, as well as to identify popular types of electronic media, in pregnant women, in order to improve strategies for the prevention or cessation of smoking among such women.
  
  
  METHODS
  A cross-sectional study involving 61 pregnant women, seen at primary care clinics and at a university hospital, in the city of Botucatu, Brazil. For all subjects, we applied the Hospital Anxiety and Depression Scale. For subjects with a history of smoking, we also applied the Fagerström Test for Nicotine Dependence, and we evaluated the level of motivation to quit smoking among the current smokers.
  
  
  RESULTS
  Of the 61 pregnant women evaluated, 25 (40.9%) were smokers (mean age, 26.4 ± 7.4 years), 24 (39.3%) were former smokers (26.4 ± 8.3 years), and 12 (19.8%) were never-smokers (25.1 ± 7.2 years). Thirty-nine women (63.9%) reported exposure to passive smoking. Of the 49 smokers/former smokers, 13 (26.5%) were aware of the pulmonary consequences of smoking; only 2 (4.1%) were aware of the cardiovascular risks; 23 (46.9%) believed that smoking does not harm the fetus or newborn infant; 21 (42.9%) drank alcohol during pregnancy; 18 (36.7%) reported increased cigarette consumption when drinking; 25 (51.0%) had smoked flavored cigarettes; and 12 (24.5%) had smoked a narghile. Among the 61 pregnant women evaluated, television was the most widely available and favorite form of electronic media (in 85.2%), as well as being the form most preferred (by 49.2%).
  
  
  CONCLUSIONS
  Among pregnant women, active smoking, passive smoking, and alternative forms of tobacco consumption appear to be highly prevalent, and such women seem to possess little knowledge about the consequences of tobacco use. Educational programs that include information about the consequences of all forms of tobacco use, employing new and effective formats tailored to this particular population, should be developed, in order to promote smoking prevention and cessation among pregnant women. Further samples to explore regional and cultural adaptations should be evaluated.
authors.affiliation: São Paulo State University, Botucatu School of Medicine, Department of Clinical Medicine, Botucatu, Brazil. Pulmonology Division, Department of Clinical Medicine, Botucatu School of Medicine, São Paulo State University, Botucatu, Brazil.
authors.forename: André Luís
authors.initials: AL
authors.lastname: Bertani
authors.affiliation: São Paulo State University, Botucatu School of Medicine, Botucatu Hospital das Clínicas, Botucatu, Brazil. Botucatu Hospital das Clínicas, Botucatu School of Medicine, São Paulo State University, Botucatu, Brazil.
authors.forename: Thais
authors.initials: T
authors.lastname: Garcia
authors.affiliation: São Paulo State University, Botucatu School of Medicine, Department of Internal Medicine, Botucatu, Brazil. Pulmonology Division, Department of Internal Medicine, Botucatu School of Medicine, São Paulo State University, Botucatu, Brazil.
authors.forename: Suzana Erico
authors.initials: SE
authors.lastname: Tanni
authors.affiliation: São Paulo State University, Botucatu School of Medicine, Department of Internal Medicine, Botucatu, Brazil. Pulmonology Division, Department of Internal Medicine, Botucatu School of Medicine, São Paulo State University, Botucatu, Brazil.
authors.forename: Irma
authors.initials: I
authors.lastname: Godoy
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008402:Mass Media; D011247:Pregnancy; D015995:Prevalence; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D014026:Nicotiana
keywords: Health knowledge, attitudes, practice; Mass media; Pregnancy; Primary prevention; Smoking; Smoking cessation