title: Smoking during pregnancy: a difficult problem to face. Results of a French multi-center study.
abstract: Smoking tobacco during pregnancy is a preventable risk factor for adverse pregnancy outcomes. The aim of the study was to assess the impact of an information and training program implemented by the perinatal network of Auvergne, France, on smoking during pregnancy.
  
  
  
  A multi-center before-and-after population-based study, based on two cross-sectional surveys, was carried out between July 2003 and June 2004, and between December 2008 and January 2010. Pregnant women aged over 18 years, with a fluent command of written and spoken French, were eligible. The main outcome was the prevalence of pregnant women who smoked daily. The preventive program consisted of informing women and healthcare providers and training healthcare providers. Multivariate analysis was performed by means of manual logistic regression and crude and adjusted Odds Ratios were calculated.
  
  
  
  "Before" and "after" surveys involved 1027 and 720 women, respectively. In the "after" survey, a higher percentage of women smoked daily at the time of diagnosis (43.49% vs 51.94%, adjusted Odds Ratio 1.45 [1.10; 1.90]) and during the third term (40.53% vs 51.94%, adjusted Odds Ratio 1.62 [1.24; 2.12]). Environmental tobacco smoke exposure among non-smokers was higher in the "after" survey: 52.83% vs 69.57% adjusted Odds Ratio 1.95 [1.54; 2.47].
  
  
  
  The program did not reduce smoking during pregnancy. Exposure to environmental tobacco smoke increased. French public health authorities should introduce a new policy aimed specifically at tackling tobacco use during pregnancy and exposure to second-hand smoke, and which takes into account the entire environment of pregnant women.
authors: Service de Santé Publique, CHU de Clermont-Ferrand, Clermont-Ferrand, France;; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), Clermont-Ferrand, France.
authors: M
authors: M
authors: Blanquet
authors: Service de Santé Publique, CHU de Clermont-Ferrand, Clermont-Ferrand, France;; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), Clermont-Ferrand, France,; Laboratoire de Mathématiques UMR CNRS 6620, Université Blaise Pascal Clermont-Ferrand;
authors: S
authors: S
authors: Leger
authors: Service de Santé Publique, CHU de Clermont-Ferrand, Clermont-Ferrand, France;; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), Clermont-Ferrand, France.
authors: L
authors: L
authors: Gerbaud
authors: Service de Santé Publique, CHU de Clermont-Ferrand, Clermont-Ferrand, France;; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), Clermont-Ferrand, France,; Pôle de Gynécologie Obstétrique et Reproduction Humaine, CHU de Clermont-Ferrand, Clermont-Ferrand, France;; Réseau de Santé Périnatale d'Auvergne.
authors: F
authors: F
authors: Vendittelli
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D037841:Pregnant People; D012307:Risk Factors; D012907:Smoking; D016540:Smoking Cessation; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Environmental tobacco smoke; Pregnancy; Tobacco consumption