Michele Bloch ^1*, Fernando Althabe ², Marie Onyamboko ³, Christine Kaseba-Sata ⁴, Eduardo E. Castilla ⁵, Salvio Freire ⁶, Ana L. Garces ⁷, Sailajanandan Parida ⁸, Shivaprasad S. Goudar ⁹, Muhammad Masood Kadir ¹⁰, Norman Goco ¹¹, Jutta Thornberry ¹¹, Magdalena Daniels ¹¹, Janet Bartz ¹¹, Tyler Hartwell ¹¹, Nancy Moss ¹², Robert Goldenberg ¹³

¹ NIH
² Perinatal Research Unit, Hospital de Clinicas, Montevideo, Urugay
³ Kinshasa School of Public Health, University of Kinshasa, Kinshasa, DRC
⁴ University Teaching Hospital, Lusaka, Zambia
⁵ Estudio Colaborativo Latinoamericano de Malformaciones Congenitas (ECLAMC), Rio de Janeiro, Brazil
⁶ Hospital das Clinicas, Federal University of Pernambuco, Recife-Pernambuco, Brazil
⁷ Multidisciplinary Health Institute, Guatemala City, Guatemala
⁸ S.C.B. Medical College, Orissa, India
⁹ KLE Society's JN Medical College, Karnataka, India
¹⁰ The Aga Khan University, Karachi, Pakistan
¹¹ Research Triangle Institute
¹² National Institute of Child Health and Human Development
¹³ Drexel University College of Medicine

^* To whom correspondence should be addressed. E-mail: blochm{at}mail.nih.gov.

	Abstract

Objectives. We examined pregnant women’s use of cigarettes and other tobacco products to determine the potential of exposure of pregnant women and their young children to secondhand smoke (SHS) in 9 nations in Latin America, Asia, and Africa.

Methods. Self-reported data were collected from face-to-face surveys administered to 7961 pregnant women (more than 700 per site) between October 2004 and September 2005.

Results. At all Latin American sites, pregnant women commonly reported that they had ever tried cigarette smoking (range: 78.3% [Uruguay] to 35.0% [Guatemala]). The highest levels of current smoking were found in Uruguay (18.3%), Argentina (10.3%), and Brazil (6.1%). Experimentation with smokeless tobacco occurred in the Democratic Republic of the Congo and India; one third of all respondents in Orissa, India, were current smokeless tobacco users. SHS exposure was common: between 91.6% (Pakistan) and 17.1% (Democratic Republic of the Congo) of pregnant women reported that smoking was permitted in their home.

Conclusions. Pregnant women’s tobacco use and SHS exposure are current or emerging problems in several low- and middle-income nations, jeopardizing ongoing efforts to improve maternal and child health.

Key Words: Global Health, Pregnancy, Secondhand Smoke, Tobacco Control, Women's Health