Posted: April 30th, 2022

Reducing Tobacco Use and Exposure in Pregnancy

Reducing Tobacco Use and Exposure in Pregnancy

Tobacco use and exposure to second-hand smoke (SHS) during pregnancy have adverse health effects on women and infants. According to the World Health Organization (WHO), tobacco use and SHS exposure can increase the risk of miscarriage, stillbirth, preterm birth, low birth weight, congenital anomalies, and sudden infant death syndrome (SIDS) . Moreover, tobacco use and SHS exposure can also harm the health of the mother, causing cardiovascular diseases, respiratory diseases, and cancers .

Despite the well-known harms of tobacco use and SHS exposure in pregnancy, many women continue to smoke or use smokeless tobacco products, or are exposed to SHS from their partners or other household members. The prevalence of tobacco use and SHS exposure in pregnancy varies widely across countries and regions, but it is generally higher in low- and middle-income countries than in high-income countries . For example, a study in Kenya found that 8.5% of pregnant women smoked cigarettes, 2.9% used smokeless tobacco, and 15.8% were exposed to SHS at home .

To reduce tobacco use and SHS exposure in pregnancy, the WHO has developed evidence-based recommendations for the prevention and management of these risk factors . These recommendations cover the following issues:

– Elements necessary for effective screening of pregnant women for tobacco use (smoked and smokeless) and SHS exposure. The WHO recommends that all pregnant women should be asked about their tobacco use and SHS exposure at their first antenatal care visit, and that this information should be recorded in their medical records. The WHO also recommends that pregnant women should be screened for their readiness to quit tobacco use or avoid SHS exposure, and that they should be offered brief advice or counselling accordingly .
– Safety and effectiveness of psychosocial and pharmacological interventions for tobacco use in pregnancy. The WHO recommends that pregnant women who smoke or use smokeless tobacco should be offered evidence-based psychosocial interventions to help them quit, such as cognitive-behavioral therapy (CBT), motivational interviewing (MI), or self-help materials. The WHO also recommends that pregnant women who are unable to quit with psychosocial interventions alone should be offered nicotine replacement therapy (NRT) as an adjunctive treatment, after considering the potential benefits and harms of NRT compared to continued tobacco use .
– Effective interventions for reducing SHS exposure at work and in public places, at home. The WHO recommends that pregnant women who are exposed to SHS at work or in public places should be advised to avoid or minimize their exposure by changing their environment or behavior. The WHO also recommends that pregnant women who are exposed to SHS at home should be encouraged to negotiate with their partners or other household members to stop smoking indoors or to smoke outside the home .

These recommendations are based on a systematic review of the available scientific evidence, as well as on the opinions of experts and stakeholders from different regions and disciplines. The recommendations are intended to guide health-care providers and other related service providers in delivering high-quality care to pregnant women who use tobacco or are exposed to SHS. The implementation of these recommendations may require adaptation to the local context, resources, and preferences of the pregnant women and their families.

Reducing tobacco use and exposure to SHS in pregnancy is a crucial step towards improving maternal and child health outcomes, as well as preventing non-communicable diseases in the long term. By following these recommendations, health-care providers and other related service providers can help pregnant women quit tobacco use or avoid SHS exposure, and thus protect their own health and the health of their infants.

Bibliography
: WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy i need help writing my dissertation. Geneva: World Health Organization; 2013. Available from: https://apps.who.int/iris/bitstream/handle/10665/94555/9789241506076_eng.pdf?sequence=1
: Mbugua SK, Wanjiru R, Njeru EK, Kiarie JN. Prevalence of cigarette smoking among pregnant women attending antenatal clinics in Nairobi County: a cross-sectional study. BMC Public Health. 2020;20(1):1347. Available from: https://doi.org/10.1186/s12889-020-09441-0

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