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Int. J. Environ. Res. Public Health 2018, 15(1), 83; https://doi.org/10.3390/ijerph15010083

Impact of Smoking Ban on Passive Smoke Exposure in Pregnant Non-Smokers in the Southeastern United States

1
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2608 Erwin Road, Durham, NC 27705, USA
2
Health Behavior and Policy, Virginia Commonwealth University, PO Box 980430, Richmond, VA 23298, USA
3
Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Campus Box 7633, Raleigh, NC 27695, USA
4
Department of Obstetrics and Gynecology, Duke University Medical Center, Box 91012, Durham, NC 27708, USA
5
Nicholas School of the Environment & Duke Global Health Institute, 308 Research Drive, Durham, NC 27701, USA
*
Author to whom correspondence should be addressed.
Received: 31 October 2017 / Revised: 3 January 2018 / Accepted: 3 January 2018 / Published: 6 January 2018
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Abstract

Prenatal passive smoke exposure raises risk for negative birth outcomes. Legislation regulating public smoking has been shown to impact exposure levels, though fewer studies involving pregnant women have been conducted within the U.S. where bans are inconsistent across regions. This study examined the effect of a ban enacted in the southeastern U.S. on pregnant women’s cotinine levels. Additional analyses compared self-reported exposure to cotinine and identified characteristics associated with passive exposure. Pregnant women (N = 851) were recruited prospectively between 2005 and 2011 in North Carolina. Sociodemographic and health data were collected via surveys; maternal blood samples were assayed for cotinine. Among non-active smokers who provided self-report data regarding passive exposure (N = 503), 20% were inconsistent with corresponding cotinine. Among all non-smokers (N = 668), being unmarried, African American, and less educated were each associated with greater passive exposure. Controlling for covariates, mean cotinine was higher prior to the ban compared to after, F(1, 640) = 24.65, p < 0.001. Results suggest that banning smoking in public spaces may reduce passive smoke exposure for non-smoking pregnant women. These data are some of the first to examine the impact of legislation on passive smoke exposure in pregnant women within the U.S. using a biomarker and can inform policy in regions lacking comprehensive smoke-free legislation. View Full-Text
Keywords: passive smoke exposure; environmental smoke exposure; secondhand smoke exposure; pregnancy; prenatal exposures; cotinine; biomarker; smoking; public policy; smoking ban passive smoke exposure; environmental smoke exposure; secondhand smoke exposure; pregnancy; prenatal exposures; cotinine; biomarker; smoking; public policy; smoking ban
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Schechter, J.C.; Fuemmeler, B.F.; Hoyo, C.; Murphy, S.K.; Zhang, J.J.; Kollins, S.H. Impact of Smoking Ban on Passive Smoke Exposure in Pregnant Non-Smokers in the Southeastern United States. Int. J. Environ. Res. Public Health 2018, 15, 83.

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