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Though smoking during pregnancy is a key cause of slowed fetal growth, miscarriage and infant death, very little is known about smoking in California. This study is measuring tobacco exposure in pregnant women from ten racial groups not previously studied, including: Native Americans, Chinese, Japanese, Koreans, Filipinos, Cambodians, Vietnamese, Laotians, Asian Indians and Samoans. We want to find out if there are differences across these groups in tobacco use during pregnancy and in the level of second hand smoke breathed in by these women. We would like to determine if pregnant women cut down or quit smoking or if household members stopped smoking in the home during pregnancy differently across these groups. We would like to know if there are ZIP Code areas where it is more common for pregnant women to smoke or where it is more common for pregnant women to be exposed to high levels of second hand smoke. We also want to learn whether second hand smoke exposure has a larger effect on lowering the average birth weight in some racial groups than others.
In the first year of the study, we analyzed data collected in the hospital at delivery as part of another TRDRP-funded study (Project Baby’s Breath). The study population for this analysis comes from San Diego County, and includes over 20,000 women, though some of our subgroups are small in size (<100 women). We found large differences in both active and passive tobacco exposure across the ten racial groups. Native Americans and Samoans reported the highest tobacco usage before or during pregnancy (>25%), while Asian Indians, Laotians and Chinese reported the lowest usage (<1%). Quitting during pregnancy was reported in all subgroups that smoked before pregnancy, with the largest declines occurring in the first trimester. Smokers reported substantially higher passive smoke exposure levels than nonsmokers. Among nonsmoking pregnant women, the proportion of households with reported smokers was highest for Samoans, Koreans, and Filipinas (>25%), and lowest for Asian Indians and Cambodians (0%).
In the upcoming years, we will verify the accuracy of the above self-reported tobacco data through analysis of cotinine in maternal blood collected in midpregnancy. Cotinine is a marker in the blood that measures how much exposure one has recently had to tobacco either from smoking or from breathing in second hand smoke. For these analyses, approximately 3,000 pregnant women will be selected from those who enrolled in the State’s prenatal screening program in Orange, San Diego, and Imperial Counties from 2000 to 2002. We will analyze the cotinine results to find out the proportion of each racial group that smokes at midpregnancy, and how exposed the others are to second hand smoke. We will also learn the characteristics of both women who smoke at midpregnancy and who are most exposed to second hand smoke.
We believe that the results of this study will help tobacco prevention services target the subgroups of pregnant women most in need. |
