Special Issue "Tackling Tobacco Use during Pregnancy and Early Childhood—Social, Economical and Health Implications"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Public Health Statistics and Risk Assessment".

Deadline for manuscript submissions: 20 November 2020.

Special Issue Editors

Dr. Gillian Gould
Website
Guest Editor
School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
Interests: maternal smoking; Indigenous health; smoking cessation; behavior change; health promotion; health services; primary care; media; ArtsHealth
Dr. Yael Bar-Zeev
Website
Guest Editor
Braun School of Public Health and Community Medicine, The Hebrew University-Hadassah, Jerusalem, Israel
Interests: tobacco control; health promotion; maternal smoking; smoking cessation; second-hand smoke exposure; behavior change; implementation science
Dr. Michelle Bovill
Website
Guest Editor
Thurru Indigenous Health Unit, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2300, Australia
Interests: Indigenous health; research ethics; smoking cessation; maternal health; implementation science; tobacco control

Special Issue Information

Dear Colleagues,

Tobacco use, including smoking, during pregnancy remains a major reversible risk factor impacting the health of expectant women and their babies. Second-hand smoke exposure also has similar effects on mother and child. Despite reductions of tobacco use rates globally, for some high-priority population groups tobacco use is still a fact of life and may even be increasing in some women. Women living in countries where smoking is mainly a male pursuit are still highly affected by smoking in the home. Strategies to reduce the use of tobacco, unless carefully planned, may increase the health gap for these populations. In pregnancy there are several additional factors that need to be taken into consideration that make it harder for women to quit, such as increased rate of nicotine metabolism, uncertainty about medication use and harm reduction strategies, and sensitive issues of health provider-patient communication when women are pregnant. Yet, women, around the time of pregnancy, and if they know the risks, are often motivated to cease tobacco use for the health of their baby. Women are positive role models and can influence family tobacco use and help create smoke-free environments. The benefits of quitting tobacco use during and around the time of pregnancy extend into social and economic benefits. In this Special Issue, we take a broad view of the benefits of women, children and families tackling tobacco use during this important time, from health, social and economic perspectives. Strategies reported in publications can include policy, public health, mass media, community, family, clinical and individual. We are interested in systematic reviews, empirical research and opinion pieces.

Assoc. Prof. Gillian Gould
Dr. Yael Bar-Zeev
Dr. Michelle Bovill
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Smoking
  • Tobacco use
  • Harm reduction
  • Smoking cessation
  • Electronic cigarettes
  • Second-hand smoke
  • Pregnancy
  • Postnatal
  • Prenatal
  • Children

Published Papers (7 papers)

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Research

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Open AccessArticle
Supports Used by Aboriginal and Torres Strait Islander Women for Their Health, including Smoking Cessation, and a Baby’s Health: A Cross-Sectional Survey in New South Wales, Australia
Int. J. Environ. Res. Public Health 2020, 17(21), 7766; https://doi.org/10.3390/ijerph17217766 - 23 Oct 2020
Abstract
This study explored Aboriginal and Torres Strait Islander women’s use of supports for their general health, for smoking cessation, and the health of babies or children, and analyzed the women’s predictors for seeking types of support. Aboriginal and Torres Strait Islander women were [...] Read more.
This study explored Aboriginal and Torres Strait Islander women’s use of supports for their general health, for smoking cessation, and the health of babies or children, and analyzed the women’s predictors for seeking types of support. Aboriginal and Torres Strait Islander women were recruited for a cross-sectional survey in two regions of NSW N = 132. The 19-item survey questioned the likelihood that the participant would use the various supports for their health, to quit smoking, and for a baby or child’s health. Logistic regression analyses were performed on N = 98 with complete data. Older participants were less likely to use Facebook or the internet for their health, or the health of a child, but were more likely to consult with health professionals. Women who had quit smoking were less likely to use an app for their health compared to smokers. Women who had a child living in their household were less likely to use the internet for a child’s health. This community-based study revealed age-related differences for access to health services and differences according to smoking status. Patterns of internet and app use warrant further consideration when planning strategies to improve Aboriginal and Torres Strait Islander women and children’s health. Full article
Open AccessArticle
Factors Associated with Prenatal Smoking Cessation Interventions among Public Health Nurses in Japan
Int. J. Environ. Res. Public Health 2020, 17(17), 6135; https://doi.org/10.3390/ijerph17176135 - 24 Aug 2020
Abstract
This study aimed to identify the factors associated with prenatal smoking cessation interventions based on the 5As model among public health nurses (PHNs) in Japan. A nationwide cross-sectional study was conducted from December 2019 to February 2020 via a self-administered questionnaire. The study [...] Read more.
This study aimed to identify the factors associated with prenatal smoking cessation interventions based on the 5As model among public health nurses (PHNs) in Japan. A nationwide cross-sectional study was conducted from December 2019 to February 2020 via a self-administered questionnaire. The study subjects were 1988 PHNs working in 431 health centers of municipalities and special wards across the country. Of the 1988 questionnaires mailed, 521 responses (26.2%) were included in the analysis. Of the 521 responses, most of the respondents were female (98.1%) and the mean age was 37.5 years. There were statistically significant differences on age, work regions, experience years working as a PHN and smoking cessation training after becoming a PHN in implementing the 5As. Self-efficacy, professional development competency, research utilization competency, age and experience years working as a PHN were positively associated with the 5As. Social nicotine dependence was negatively associated with the 5As. Furthermore, self-efficacy mediated the relationship between the 5As and professional development competency, research utilization competency, social nicotine dependence, age and experience years working as a PHN. In the future, smoking cessation intervention training should be widely implemented to improve self-efficacy and prenatal smoking cessation interventions among Japanese PHNs. Full article
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Open AccessArticle
Inadequate Knowledge, Attitude and Practices about Second-Hand Smoke among Non-Smoking Pregnant Women in Urban Vietnam: The Need for Health Literacy Reinforcement
Int. J. Environ. Res. Public Health 2020, 17(10), 3744; https://doi.org/10.3390/ijerph17103744 - 25 May 2020
Abstract
The rate of exposure to second-hand smoke (SHS) is relatively high in several countries, including Vietnam, and health issues related to SHS have worsened in recent years, especially for pregnant women and their infants. Enhancement of knowledge, attitude, and practice (KAP) scores of [...] Read more.
The rate of exposure to second-hand smoke (SHS) is relatively high in several countries, including Vietnam, and health issues related to SHS have worsened in recent years, especially for pregnant women and their infants. Enhancement of knowledge, attitude, and practice (KAP) scores of pregnant women in Vietnam could raise practical interventions to protect their health and reduce complications of SHS. A cross-sectional study of 432 pregnant women who came to the Obstetrics Department of Bach Mai Hospital, Hanoi, Vietnam for antenatal care was conducted in 2016 to collect information about their KAP related to SHS. Composite mean scores from survey questions assessing their KAP were calculated on a 10-point scale, finding mean scores of 4.19, 7.45, and 4.30, respectively. Higher scores indicated better knowledge, attitude, and practice. Generalized linear models identified that age, occupation, living place, and sources of information were associated with SHS-related KAP. Findings from this study indicate that suitable programs related to SHS should be implemented to improve and reinforce health literacy to both mothers and smokers to reduce the harmfulness of smoking on women and their infants’ health. Full article
Open AccessArticle
Parental Perceptions of Children’s Exposure to Tobacco Smoke and Parental Smoking Behaviour
Int. J. Environ. Res. Public Health 2020, 17(10), 3397; https://doi.org/10.3390/ijerph17103397 - 13 May 2020
Cited by 1
Abstract
Around 40% of children are exposed to tobacco smoke, increasing their risk of poor health. Previous research has demonstrated misunderstanding among smoking parents regarding children’s exposure. The parental perceptions of exposure (PPE) measure uses visual and textual vignettes to assess awareness of exposure [...] Read more.
Around 40% of children are exposed to tobacco smoke, increasing their risk of poor health. Previous research has demonstrated misunderstanding among smoking parents regarding children’s exposure. The parental perceptions of exposure (PPE) measure uses visual and textual vignettes to assess awareness of exposure to smoke. The study aimed to determine whether PPE is related to biochemical and reported measures of exposure in children with smoking parents. Families with at least one smoking parent and a child ≤ age 8 were recruited. In total, 82 parents completed the PPE questionnaire, which was assessed on a scale of 1–7 with higher scores denoting a broader perception of exposure. Parents provided a sample of their child’s hair and a self-report of parental smoking habits. Parents who reported smoking away from home had higher PPE ratings than parents who smoke in and around the home (p = 0.026), constituting a medium effect size. PPE corresponded with home smoking frequency, with rare or no home exposure associated with higher PPE scores compared to daily or weekly exposure (p < 0.001). PPE was not significantly related to hair nicotine but was a significant explanatory factor for home smoking location. PPE was significantly associated with parental smoking behaviour, including location and frequency. High PPE was associated with lower exposure according to parental report. This implies that parental understanding of exposure affects protective behaviour and constitutes a potential target for intervention to help protect children. Full article
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Review

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Open AccessReview
Systematic Review of Behaviour Change Techniques within Interventions to Reduce Environmental Tobacco Smoke Exposure for Children
Int. J. Environ. Res. Public Health 2020, 17(21), 7731; https://doi.org/10.3390/ijerph17217731 - 22 Oct 2020
Abstract
Children are particularly vulnerable to environmental tobacco smoke (ETS). There is no routine support to reduce ETS in the home. We systematically reviewed trials to reduce ETS in children in order to identify intervention characteristics and behaviour change techniques (BCTs) to inform future [...] Read more.
Children are particularly vulnerable to environmental tobacco smoke (ETS). There is no routine support to reduce ETS in the home. We systematically reviewed trials to reduce ETS in children in order to identify intervention characteristics and behaviour change techniques (BCTs) to inform future interventions. We searched Medline, EMBASE, CINAHL, PsycINFO, ERIC, Cochrane Central Register of Controlled Trials, and Cochrane Tobacco Addiction Group Specialised Register from January 2017 to June 2020 to update an existing systematic review. We included controlled trials to reduce parent/caregiver smoking or ETS in children <12 years that demonstrated a statistically significant benefit, in comparison to less intensive interventions or usual care. We extracted trial characteristics; and BCTs using Behaviour Change Technique Taxonomy v1. We defined “promising” BCTs as those present in at least 25% of effective interventions. Data synthesis was narrative. We included 16 trials, of which eight were at low risk of bias. All trials used counselling in combination with self-help or other supporting materials. We identified 13 “promising” BCTs centred on education, setting goals and planning, or support to reach goals. Interventions to reduce ETS in children should incorporate effective BCTs and consider counselling and self-help as mechanisms of delivery. Full article
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Open AccessReview
Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting
Int. J. Environ. Res. Public Health 2020, 17(6), 2034; https://doi.org/10.3390/ijerph17062034 - 19 Mar 2020
Cited by 1
Abstract
The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers [...] Read more.
The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers to and facilitators of smoking cessation during pregnancy. Two databases were searched to obtain systematic reviews published from 2010 to 2019. Pertinent data from 76 articles were summarized using a narrative synthesis (PROSPERO reference: CRD42018085896). Exposure to smoke or tobacco in other forms during pregnancy is associated with an increased risk of obstetric complications and adverse health outcomes for children exposed in-utero. Counselling interventions are modestly effective, while incentive-based interventions appear to substantially increase smoking cessation. Nicotine replacement therapy is effective during pregnancy but the evidence is not conclusive. Predictors and barriers to smoking cessation in pregnancy are also discussed. Smoking during pregnancy poses substantial risk to mother’s and child’s health. Psychosocial interventions and nicotine replacement therapy (NRT) appear to be effective in helping pregnant women quit smoking. Barriers to smoking cessation must be identified and steps taken to eradicate them in order to reduce smoking among pregnant women. More research is needed on smoking cessation medications and e-cigarettes. Full article
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Other

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Open AccessCase Report
Intensive Behavioural and Pharmacological Treatment for Tobacco Dependence in Pregnant Women with Complex Psychosocial Challenges: A Case Report
Int. J. Environ. Res. Public Health 2020, 17(13), 4770; https://doi.org/10.3390/ijerph17134770 - 02 Jul 2020
Abstract
Up to 95% of women who use other substances also smoke tobacco during pregnancy. Challenging psychosocial circumstances and other barriers that contribute to high levels of tobacco dependence result in few quitting successfully. This case report describes the treatment of a highly tobacco [...] Read more.
Up to 95% of women who use other substances also smoke tobacco during pregnancy. Challenging psychosocial circumstances and other barriers that contribute to high levels of tobacco dependence result in few quitting successfully. This case report describes the treatment of a highly tobacco dependent 34-year-old pregnant woman with a history of recent substance use, mental illness and trauma, enrolled in the Incentives to Quit Tobacco in Pregnancy program. Heavy smoking, both during the day and overnight, was reported. An extensive history of quit attempts, as well as a strong desire to cease tobacco use during pregnancy, was also noted. Treatment utilising extensive behavioural supports, including financial incentives for carbon monoxide verified abstinence and telephone-based counselling, in combination with nicotine replacement therapy (NRT), was offered to assist cessation. Excellent uptake and adherence to all aspects of treatment saw tobacco cessation achieved and maintained for 24 weeks while on the program. NRT used at doses well above those recommended for pregnancy was required to alleviate strong withdrawal symptoms and maintain abstinence. Daily monitoring of carbon monoxide, financial incentives for continued abstinence and regular phone support were critical to maintaining motivation and preventing relapse to smoking. Post-program relapse to smoking did occur, as is common, and highlights the need for longer-term intensive support for pregnant women with complex behavioural and social problems. Given the prevalence of tobacco smoking in such populations, long-term harm reduction treatment models using extensive behavioural support in combination with NRT should be considered for inclusion in current smoking cessation guidelines. Full article
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