Environmental Tobacco Smoke Avoidance Among Pregnant African-American Nonsmokers

Susan M. Blake, Kennan D. Murray, M. Nabil El-Khorazaty, Marie G. Gantz, Michele Kiely, Dana Best, Jill G Joseph, Ayman A E El-Mohandes

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Environmental tobacco smoke (ETS) exposure during pregnancy contributes to adverse infant health outcomes. Limited previous research has focused on identifying correlates of ETS avoidance. This study sought to identify proximal and more distal correlates of ETS avoidance early in pregnancy among African-American women. Methods: From a sample of low-income, black women (n=1044) recruited in six urban, prenatal care clinics (July 2001-October 2003), cotinine-confirmed nonsmokers with partners, household/family members, or friends who smoked (n=450) were identified and divided into two groups: any past-7-day ETS exposure and cotinine-confirmed ETS avoidance. Bivariate and multivariate logistic regression analyses identified factors associated with ETS avoidance. Data were initially analyzed in 2004. Final models were reviewed and revised in 2007 and 2008. Results: Twenty-seven percent of pregnant nonsmokers were confirmed as ETS avoiders. In multivariate logistic regression analysis, the odds of ETS avoidance were increased among women who reported household smoking bans (OR=2.96; 95% CI=1.83, 4.77; p<0.0001), that the father wanted the baby (OR=2.70; CI=1.26, 5.76; p=0.01), and that no/few family members/friends smoked (OR=3.15; 95% CI=1.58, 6.29; p<0.001). The odds were decreased among women who had a current partner (OR=0.42; 95% CI=0.23, 0.76; p<0.01), reported any intimate partner violence during pregnancy (OR=0.43; 95% CI=0.19, 0.95; p<0.05), and reported little social support to prevent ETS exposure (OR=0.50; 95% CI=0.30, 0.85; p=0.01). Parity, emotional coping strategies, substance use during pregnancy, partner/household member smoking status, and self-confidence in avoiding ETS were significant in bivariate, but not multivariate analyses. Conclusions: Social contextual factors were the strongest determinants of ETS avoidance during pregnancy. Results highlight the importance of prenatal screening to identify pregnant nonsmokers at risk, encouraging household smoking bans, gaining support from significant others, and fully understanding the interpersonal context of a woman's pregnancy before providing behavioral counseling and advice to prevent ETS exposure.

Original languageEnglish (US)
Pages (from-to)225-234
Number of pages10
JournalAmerican Journal of Preventive Medicine
Volume36
Issue number3
DOIs
StatePublished - Mar 2009
Externally publishedYes

Fingerprint

Smoke
African Americans
Tobacco
Pregnancy
Cotinine
Smoking
Logistic Models
Regression Analysis
Prenatal Care
Parity
Prenatal Diagnosis
Fathers
Social Support
Counseling
Multivariate Analysis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Blake, S. M., Murray, K. D., El-Khorazaty, M. N., Gantz, M. G., Kiely, M., Best, D., ... El-Mohandes, A. A. E. (2009). Environmental Tobacco Smoke Avoidance Among Pregnant African-American Nonsmokers. American Journal of Preventive Medicine, 36(3), 225-234. https://doi.org/10.1016/j.amepre.2008.10.012

Environmental Tobacco Smoke Avoidance Among Pregnant African-American Nonsmokers. / Blake, Susan M.; Murray, Kennan D.; El-Khorazaty, M. Nabil; Gantz, Marie G.; Kiely, Michele; Best, Dana; Joseph, Jill G; El-Mohandes, Ayman A E.

In: American Journal of Preventive Medicine, Vol. 36, No. 3, 03.2009, p. 225-234.

Research output: Contribution to journalArticle

Blake, SM, Murray, KD, El-Khorazaty, MN, Gantz, MG, Kiely, M, Best, D, Joseph, JG & El-Mohandes, AAE 2009, 'Environmental Tobacco Smoke Avoidance Among Pregnant African-American Nonsmokers', American Journal of Preventive Medicine, vol. 36, no. 3, pp. 225-234. https://doi.org/10.1016/j.amepre.2008.10.012
Blake, Susan M. ; Murray, Kennan D. ; El-Khorazaty, M. Nabil ; Gantz, Marie G. ; Kiely, Michele ; Best, Dana ; Joseph, Jill G ; El-Mohandes, Ayman A E. / Environmental Tobacco Smoke Avoidance Among Pregnant African-American Nonsmokers. In: American Journal of Preventive Medicine. 2009 ; Vol. 36, No. 3. pp. 225-234.
@article{4be3274c946c477b887471fa4b9d6fa2,
title = "Environmental Tobacco Smoke Avoidance Among Pregnant African-American Nonsmokers",
abstract = "Background: Environmental tobacco smoke (ETS) exposure during pregnancy contributes to adverse infant health outcomes. Limited previous research has focused on identifying correlates of ETS avoidance. This study sought to identify proximal and more distal correlates of ETS avoidance early in pregnancy among African-American women. Methods: From a sample of low-income, black women (n=1044) recruited in six urban, prenatal care clinics (July 2001-October 2003), cotinine-confirmed nonsmokers with partners, household/family members, or friends who smoked (n=450) were identified and divided into two groups: any past-7-day ETS exposure and cotinine-confirmed ETS avoidance. Bivariate and multivariate logistic regression analyses identified factors associated with ETS avoidance. Data were initially analyzed in 2004. Final models were reviewed and revised in 2007 and 2008. Results: Twenty-seven percent of pregnant nonsmokers were confirmed as ETS avoiders. In multivariate logistic regression analysis, the odds of ETS avoidance were increased among women who reported household smoking bans (OR=2.96; 95{\%} CI=1.83, 4.77; p<0.0001), that the father wanted the baby (OR=2.70; CI=1.26, 5.76; p=0.01), and that no/few family members/friends smoked (OR=3.15; 95{\%} CI=1.58, 6.29; p<0.001). The odds were decreased among women who had a current partner (OR=0.42; 95{\%} CI=0.23, 0.76; p<0.01), reported any intimate partner violence during pregnancy (OR=0.43; 95{\%} CI=0.19, 0.95; p<0.05), and reported little social support to prevent ETS exposure (OR=0.50; 95{\%} CI=0.30, 0.85; p=0.01). Parity, emotional coping strategies, substance use during pregnancy, partner/household member smoking status, and self-confidence in avoiding ETS were significant in bivariate, but not multivariate analyses. Conclusions: Social contextual factors were the strongest determinants of ETS avoidance during pregnancy. Results highlight the importance of prenatal screening to identify pregnant nonsmokers at risk, encouraging household smoking bans, gaining support from significant others, and fully understanding the interpersonal context of a woman's pregnancy before providing behavioral counseling and advice to prevent ETS exposure.",
author = "Blake, {Susan M.} and Murray, {Kennan D.} and El-Khorazaty, {M. Nabil} and Gantz, {Marie G.} and Michele Kiely and Dana Best and Joseph, {Jill G} and El-Mohandes, {Ayman A E}",
year = "2009",
month = "3",
doi = "10.1016/j.amepre.2008.10.012",
language = "English (US)",
volume = "36",
pages = "225--234",
journal = "American Journal of Preventive Medicine",
issn = "0749-3797",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Environmental Tobacco Smoke Avoidance Among Pregnant African-American Nonsmokers

AU - Blake, Susan M.

AU - Murray, Kennan D.

AU - El-Khorazaty, M. Nabil

AU - Gantz, Marie G.

AU - Kiely, Michele

AU - Best, Dana

AU - Joseph, Jill G

AU - El-Mohandes, Ayman A E

PY - 2009/3

Y1 - 2009/3

N2 - Background: Environmental tobacco smoke (ETS) exposure during pregnancy contributes to adverse infant health outcomes. Limited previous research has focused on identifying correlates of ETS avoidance. This study sought to identify proximal and more distal correlates of ETS avoidance early in pregnancy among African-American women. Methods: From a sample of low-income, black women (n=1044) recruited in six urban, prenatal care clinics (July 2001-October 2003), cotinine-confirmed nonsmokers with partners, household/family members, or friends who smoked (n=450) were identified and divided into two groups: any past-7-day ETS exposure and cotinine-confirmed ETS avoidance. Bivariate and multivariate logistic regression analyses identified factors associated with ETS avoidance. Data were initially analyzed in 2004. Final models were reviewed and revised in 2007 and 2008. Results: Twenty-seven percent of pregnant nonsmokers were confirmed as ETS avoiders. In multivariate logistic regression analysis, the odds of ETS avoidance were increased among women who reported household smoking bans (OR=2.96; 95% CI=1.83, 4.77; p<0.0001), that the father wanted the baby (OR=2.70; CI=1.26, 5.76; p=0.01), and that no/few family members/friends smoked (OR=3.15; 95% CI=1.58, 6.29; p<0.001). The odds were decreased among women who had a current partner (OR=0.42; 95% CI=0.23, 0.76; p<0.01), reported any intimate partner violence during pregnancy (OR=0.43; 95% CI=0.19, 0.95; p<0.05), and reported little social support to prevent ETS exposure (OR=0.50; 95% CI=0.30, 0.85; p=0.01). Parity, emotional coping strategies, substance use during pregnancy, partner/household member smoking status, and self-confidence in avoiding ETS were significant in bivariate, but not multivariate analyses. Conclusions: Social contextual factors were the strongest determinants of ETS avoidance during pregnancy. Results highlight the importance of prenatal screening to identify pregnant nonsmokers at risk, encouraging household smoking bans, gaining support from significant others, and fully understanding the interpersonal context of a woman's pregnancy before providing behavioral counseling and advice to prevent ETS exposure.

AB - Background: Environmental tobacco smoke (ETS) exposure during pregnancy contributes to adverse infant health outcomes. Limited previous research has focused on identifying correlates of ETS avoidance. This study sought to identify proximal and more distal correlates of ETS avoidance early in pregnancy among African-American women. Methods: From a sample of low-income, black women (n=1044) recruited in six urban, prenatal care clinics (July 2001-October 2003), cotinine-confirmed nonsmokers with partners, household/family members, or friends who smoked (n=450) were identified and divided into two groups: any past-7-day ETS exposure and cotinine-confirmed ETS avoidance. Bivariate and multivariate logistic regression analyses identified factors associated with ETS avoidance. Data were initially analyzed in 2004. Final models were reviewed and revised in 2007 and 2008. Results: Twenty-seven percent of pregnant nonsmokers were confirmed as ETS avoiders. In multivariate logistic regression analysis, the odds of ETS avoidance were increased among women who reported household smoking bans (OR=2.96; 95% CI=1.83, 4.77; p<0.0001), that the father wanted the baby (OR=2.70; CI=1.26, 5.76; p=0.01), and that no/few family members/friends smoked (OR=3.15; 95% CI=1.58, 6.29; p<0.001). The odds were decreased among women who had a current partner (OR=0.42; 95% CI=0.23, 0.76; p<0.01), reported any intimate partner violence during pregnancy (OR=0.43; 95% CI=0.19, 0.95; p<0.05), and reported little social support to prevent ETS exposure (OR=0.50; 95% CI=0.30, 0.85; p=0.01). Parity, emotional coping strategies, substance use during pregnancy, partner/household member smoking status, and self-confidence in avoiding ETS were significant in bivariate, but not multivariate analyses. Conclusions: Social contextual factors were the strongest determinants of ETS avoidance during pregnancy. Results highlight the importance of prenatal screening to identify pregnant nonsmokers at risk, encouraging household smoking bans, gaining support from significant others, and fully understanding the interpersonal context of a woman's pregnancy before providing behavioral counseling and advice to prevent ETS exposure.

UR - http://www.scopus.com/inward/record.url?scp=59649124254&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=59649124254&partnerID=8YFLogxK

U2 - 10.1016/j.amepre.2008.10.012

DO - 10.1016/j.amepre.2008.10.012

M3 - Article

C2 - 19215848

AN - SCOPUS:59649124254

VL - 36

SP - 225

EP - 234

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

SN - 0749-3797

IS - 3

ER -