Objective: To estimate the frequency of pregnant women who are passive or active smokers and determine the degree of their exposure.
Study Design: Cross sectional questionnaire survey.
Place And Duration Of Study: Antenatal Outpatients, MCH Centre, Pakistan Institute of Medical Sciences, Islamabad, Pakistan from 1st to 30th November 2006.
Patients and Methods: Pregnant women attending the antenatal outpatient clinic were interviewed from a pre designed questionnaire by obstetric residents after informed consent. The outcome measures were to estimate the frequency of active and passive smoking and ascertain the relationship with active smokers. The smoking habits were then correlated with the social status and family system.
Results: Of the 638 interviewed pregnant women, there was one (0.15%) active smoker and 80 (12.5%) passive smokers. Eight (10%) passive smokers were exposed to tobacco smoke at the parental home as well. Among 80 passive smokers, 4(5%) were working women with exposure to cigarette smoke at the place of work while the rest were housewives. Sixty one (76%) women lived in combined family system. The active smoker was the husband in 48(60%) while other male household members also smoked in the rest of the cases. Mothers-in-law smoked Huqqa (Hubble bubble) in 4 (5%) instances. The husbands smoked a mean of 20 cigarettes per day (range 3-60). Sixty eight (85%) husbands were employed with majority doing work in the private sector and only 12 (17.5%) were government servants.
Conclusion: Passive smoking is an evolving health problem. However low frequency of smoking among pregnant women is encouraging and needs to be sustained.
Key Words: Smoking, pregnancy, passive smoking, active smoker, tobacco.

Introduction

Tobacco smoking is responsible for highest rates of preventable diseases and premature deaths. There are 1.3 billion smokers worldwide in a world population of about 6.6 billion. Globally about 200 million women are smokers. 84% of all smokers are in the developing countries. Around half of regular smokers who begin smoking during adolescence will eventually be killed by tobacco.1 About 5 million smoking related deaths occur annually. If these trends continue it is estimated that 10 million lives may be lost globally by the year 2020.² It is common knowledge that cigarette smoking and tobacco use is associated with higher incidence of lung cancer, oral cavity, bladder and larynx cancer as well as chronic obstructive pulmonary disease, ischemic heart disease and other diseases of vascular system.
Tobacco smoking is associated with higher rates of gynecological diseases including sexually transmitted diseases, vulvo-vaginitis, pelvic inflammatory disease and cervical carcinomas.³ During pregnancy the habit of smoking results in higher early pregnancy losses, intrauterine growth restriction and premature birth. The perinatal mortality rates are higher and Apgar scores lower in infants born to smoking mothers.⁴ Babies exposed to tobacco smoke have higher risk of asthma and sudden infant death.
Involuntary exposure of non smokers to environmental tobacco smoke has been an increasingly important public health concern as studies have reported 20-30% increased lung cancer rates and 10-43% increased chronic respiratory disease amongst this population.^5,6 The 2004 Surgeon General Report of USA had focused on specific outcomes of fertility, developmental and reproductive outcomes and perinatal morbidity in relation to second hand smoking.⁷ This is with the background that 28% men, 24% women and 11% pregnant women smoke in the USA. In Pakistan there are 22-25 million (21%) tobacco users and 55% of households have at least one tobacco smoker.⁸
The present study had the aim of ascertaining the frequency of active and passive smoking and it relation to socioeconomic status and family system among pregnant women receiving antenatal care at our postgraduate, teaching, tertiary care public hospital.

Download Here For Complete Article