title: Prevalence of Tobacco Smoking and Accuracy of Self-Reporting in Pregnant Women at a Public Hospital for Women and Children.
abstract: BACKGROUND
  Denial of smoking status by pregnant women presents a missed opportunity for referral to smoking cessation programmes that are shown to be effective in helping them quit smoking.
  
  
  METHODS
  A cross-sectional epidemiological survey was conducted to detect the true prevalence of active smoking pregnant patients and the accuracy of self-reporting, investigate the sociodemographic risk factors and test the knowledge of pregnant patients on adverse effects of smoking. This involved 972 antenatal patients of a maternity hospital where participants completed a sociodemographic data survey and answered a knowledge questionnaire. Urine cotinine testing was carried out after informed consent.
  
  
  RESULTS
  The prevalence of active smokers was 5.2% (n = 50) with 3% (n = 29) being light smokers and 2.2% (n = 21) being heavy smokers. This was significantly higher than self-reported active smoking status of 3.7% (n = 36; P = 0.02). The Malay race, being aged less than 20 years and not having tertiary level qualifications independently increased the likelihood of being an active smoker. Knowledge of the adverse effects of smoking was generally good with a mean total score of 8.18 out of 10 but there were differences amongst the non-smokers, passive smokers, light smokers and active smokers (P = 0.012).
  
  
  CONCLUSIONS
  While the prevalence of active smoking among pregnant women is low in Singapore compared to other countries, this study substantiated the unreliability of self-reporting of smoking status in the pregnant population which could complicate referral to smoking cessation programmes. The lower awareness of the harms of smoking during pregnancy among smokers highlights a potential area for improvement.
authors.affiliation: Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.
authors.forename: Pamela Yf
authors.initials: PY
authors.lastname: Tan
authors.forename: Vasuki
authors.initials: V
authors.lastname: Utravathy
authors.forename: Lin Yoke
authors.initials: LY
authors.lastname: Ho
authors.forename: Soo Geok
authors.initials: SG
authors.lastname: Foo
authors.forename: Kelvin Kh
authors.initials: KKh
authors.lastname: Tan
mesh_terms: D000328:Adult; D000367:Age Factors; D044466:Asian People; D003367:Cotinine / Q000652:urine; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006771:Hospitals, Maternity; D006779:Hospitals, Public; D006801:Humans; D008296:Malaysia; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D037841:Pregnant People; D015995:Prevalence; D057566:Self Report; D012846:Singapore / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology* / Q000652:urine; D055815:Young Adult
chemical_list: D003367:Cotinine