Prevalence of smoking during pregnancy
Authors: Mabel Berrueta, Laura Llambi, Mercedes Colomar, Alicia Aleman
Journal: The Lancet Global Health (2018)

Shannon Lange and colleagues1Lange S Probst C Rehm J Popova S National, regional, and global prevalence of smoking during pregnancy in the general population: a systematic review and meta-analysis.Lancet Glob Health. 2018; 6: e769-e776Summary Full Text Full Text PDF PubMed Scopus (231) Google Scholar published a systematic review and meta-analysis reporting the prevalence of smoking during pregnancy by country. As the authors highlighted, Uruguay is among the top three countries with the highest prevalence, and Argentina is situated in the group of countries with a prevalence between 10% and 15%. The burden of tobacco in pregnant women in these two countries is surprisingly high since both countries have adopted comprehensive tobacco control measures. Because of this public health problem, we would like to contribute additional data, which is reported in our study of smoking patterns and receipt of cessation services among pregnant women in Argentina and Uruguay, published in 2016.2Berrueta M Morello P Alemán A et al.Smoking patterns and receipt of cessation services among pregnant women in Argentina and Uruguay.Nicotine Tob Res. 2016; 18: 1116-1125Crossref PubMed Scopus (6) Google Scholar This study presents baseline data from a cluster-randomised trial done before implementing a brief counselling intervention for smoking cessation. Data were collected prospectively, and abstinence in self-reported quitters was validated with a cotinine assessment. In the 3400 women included, we found that smoking prevalence varied by country, with Uruguay having a higher percentage of women who smoked throughout the pregnancy (26·7%) than did Argentina (16·1%).2Berrueta M Morello P Alemán A et al.Smoking patterns and receipt of cessation services among pregnant women in Argentina and Uruguay.Nicotine Tob Res. 2016; 18: 1116-1125Crossref PubMed Scopus (6) Google Scholar Most women started smoking in adolescence, suggesting that prevention strategies aimed at youth are needed in addition to cessation interventions. The results of the trial after implementing the intervention revealed that the proportion of women who continued smoking during pregnancy did not change after implementation, suggesting that women who continue to smoke at this time of life find it particularly hard to quit.3Althabe F Alemán A Berrueta M et al.A multifaceted strategy to implement brief smoking cessation counseling during antenatal care in Argentina and Uruguay: a cluster randomized trial.Nicotine Tob Res. 2016; 18: 1083-1092Crossref PubMed Scopus (12) Google Scholar Efforts are needed to develop effective interventions to decrease smoking during pregnancy. Finally, women from our study (and from other Uruguayan studies4Magri R Hutson J Míguez H et al.Advances in the determination of alcohol and other drug consumption during pregnancy: a study of 900 births in Montevideo, Uruguay.Contemp Drug Probl. 2007; 34: 445-476Crossref Google Scholar mentioned in the review) belong to socioeconomic challenged sectors, in which tobacco burden reflects broader inequalities. We declare no competing interests. National, regional, and global prevalence of smoking during pregnancy in the general population: a systematic review and meta-analysisSmoking during pregnancy is still a prevalent behaviour in many countries. These findings should inform smoking prevention programmes and health promotion strategies, as well as draw attention to the need for improved access to smoking cessation programmes for pregnant women. Full-Text PDF Open AccessPrevalence of smoking during pregnancy – Authors' replyWe thank Patrick Doorley and Joan Hanafin from Ireland and Mabel Berrueta and colleagues from Argentina and Uruguay for their comments about our Article on the global prevalence of smoking during pregnancy.1 The comments from these researchers, who represent countries with a higher than average prevalence of smoking among pregnant women,1 along with the results of our study, highlight the need to establish national surveillance systems on prenatal tobacco use and other substance use that can be used to monitor the prevalence of substance use over time, study risk factors associated with substance use, investigate possible associations between prenatal substance exposure and maternal and child health outcomes, and assess the effectiveness of policy measures. Full-Text PDF Open AccessPrevalence of smoking during pregnancyShannon Lange and colleagues (July, 2018)1 report the results of a systematic review and meta-analysis of the scientific literature from 1985 to 2016 to estimate the prevalence of smoking during pregnancy by country, WHO region, and globally. Smoking during pregnancy leads to adverse effects for women and children and this much-needed report is welcome. Estimates for smoking during pregnancy were calculated via meta-analysis for 43 countries and via statistical modelling for 131 countries. At 38%, Ireland was reported to have the highest estimated prevalence of all countries. Full-Text PDF Open Access