Intended for healthcare professionals


Prevalence of smoking among pregnant women is lower in Italy than England

BMJ 1999; 318 doi: (Published 10 April 1999) Cite this as: BMJ 1999;318:1012
  1. Liliane Chatenoud, Senior scientist.,
  2. Francesca Chiaffarino, Research fellow.,
  3. Fabio Parazzini, Head unit of analytical epidemiology.,
  4. Guido Benzi, Researcher.,
  5. Carlo La Vecchia, Associate professor of epidemiology.
  1. Istituto di Ricerche Farmacologiche “Mario Negri,” 20157 Milan, Italy
  2. Prima Clinica Ostetrico Ginecologica, Università di Milano, Milan
  3. Istituto di Statistica Medica e Biometria, Università di Milano, 20133 Milan

    EDITOR—Owen et al report that the prevalence of smoking in pregnancy and the rates of stopping did not change in England between 1992 and 1995, remaining at around 25%.1They also reported that the prevalence of smoking in pregnancy is higher in young women, unemployed women, and manual workers.

    We analysed the characteristics of women who gave up or continued smoking during pregnancy in Italy, using the comparison group of a case-control study of various obstetric conditions conducted in Italy between 1990 and 1995.2 A total of 1542 women aged 14-41 (median age 30) who delivered healthy infants at term (>37 weeks' gestation) on selected days in several hospitals, including those with the largest obstetric departments in greater Milan, were included in our analysis. Data were collected by trained interviewers using a structured questionnaire. Reliability3 and validity (based on saliva cotinine analysis4) of self reported smoking in pregnancy were satisfactory.

    Altogether 1122 (72.8%) women were never smokers at conception, 232 (15.0%) stopped during pregnancy (195 (84%) of them during the first trimester), and 188 (12.2%) smoked during pregnancy.

    The table gives the prevalence of smoking in pregnancy according to age and selected variables. The prevalence was lower in women aged <25 than in those aged ≥35(11.4% v 13.5%); the odds ratios of quitting declined with age to 0.4 (95% confidence interval 0.2 to 0.8) for women aged≥35 versus those aged <25. Never married women were more frequently smokers in pregnancy than married women (20.8% v 11.9%). More educated women were less frequently smokers than less educated women (10.0% v28.6%) and had an odds ratio of quitting of 2.4 (1.0 to 5.2). Women with two or more previous births were more frequently smokers (17.8% v 11.4%) and less frequently quit (odds ratio 0.2 (0.1 to 0.5)).

    These data show a lower reported prevalence of smoking among pregnant women in Italy than in England. This reflects a lower overall prevalence of smoking among Italian women (17% in 19955). Our data confirm the finding of Owen et al that smoking in pregnancy is more common among never married, less educated women; priority interventions should therefore be targeted at these groups.


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