SECOND-HAND SMOKE EXPOSURE IN PREGNANCY

The World Health Organization (WHO) said that tobacco use has resulted almost deaths of over six million peoples per one year. Tobacco manufacturers have to be responsible for these suffering populations since Tobacco is the only legal product that has killed a lot of consumers. WHO reports the death is occurring every six seconds and if nobody takes strong action to prevent from its occurring or to stop the increasing numbers about tobacco epidemic, the number of death will increase up to eight million per year by 2030 (1).

One of the most serious problems caused by tobacco use is exposure to tobacco smoke has negative effects on almost all stages of human reproduction. Tobacco smoking influences both male and female productivity (2) and maternal cigarette smoking is more problematic than we expected. It is strongly related with increased risks for various symptoms (e.g., ectopic pregnancy, premature rupture of membranes, abruptio placentae, placenta previa, miscarriage, stillbirth, preterm birth, low birth weight, small for gestational age, and congenital anomalies such as cleft lip) (3). Therefore, the risk for sudden infant death syndrome is increasing for women who smoked during or even after pregnancy (4).

Sometimes, not only smoking tobacco but also developing chronic illness in adulthood can cause some of theses conditions including low birth weight and preterm birth (5). The negative effects of tobacco use in pregnancy are not limited to tobacco product only. Some researchers suggest that baby born to women who did not smoke tobacco in pregnancy could also have a high risk having same symptoms like low birth weight and preterm birth (6). The harmful effects of tobacco use are not limited to only mother smoked in pregnancy, thus, any kind of maternal exposures to smoking has been related with reduced birth weight of infant and can cause increasing risk of low birth weight by 22% (7).

Additionally, tobacco use has been also indirectly associated with increasing poverty at individual, household and national scales (8). Consuming tobacco make individual and household consumers spend a lot of money that had to be spent for daily necessities and commodities inducing daily food, housing, and health care service. This situation leads increasing the negative health effects on pregnant women, their fetuses and newborns again.

Internationally, WHO recently released the data shows that 22% of adult population aged 15 and over answered that they are tobacco smokers including 36% of male and 8% of female. According to the WHO in European and Americas, they have the highest rates of tobacco smoking adult women in the world (8). There is difference in the number of smoking women according to the income levels; Lower-middle income countries have lower number of tobacco smoking women compared to upper-middle-income and high-income countries. However, the problem is global tobacco epidemics has continued to shift from high-income countries to low-income countries. Recent data tells us that increasing number of tobacco smoking among women is expected to 20% by 2025 (9).  More seriously, rising populations in tobacco use and alternative tobacco products among young females in many countries is one of potential factors of the epidemic’s growth (9).

1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 2006, 3(11):e442.

2. Alverson CJ et al. Maternal smoking and congenital heart defects in the Baltimore-Wash- ington infant study. Pediatrics, 2011, 127:3 e647–e653, [published ahead of print February 28, 2011, doi:10.1542/peds.2010–1399].

3. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the surgeon general. Atlanta, GA, US Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health, 2010.

4. The health consequences of involuntary exposure to tobacco smoke: a report of the surgeon general. Atlanta, GA, US Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health, 2006.

5. Barker DJ. The fetal and infant origins of adult disease. British Medical Journal, 1990, 301:1111.

6. Health effects of smokeless tobacco products. Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR), 2008, [available at: http://ec.europa.eu/health/ph_risk/committees/04_scenihr/docs/scenihr_o_013.pdf, [accessed 12 August 2013].

7. Leonardi-Bee J, Britton J, Venn A. Secondhand smoke and adverse fetal outcomes in nonsmoking pregnant women: a meta-analysis. Pediatrics, 2011 Apr;127(4):734–41

8. World Health Organization. The Millennium development goals and tobacco control: an opportunity for global partnership. Geneva, World Health Organization, 2004.

9. World Health Organization. WHO report on the global tobacco epidemic: warning about the dangers of tobacco. Geneva, World Health Organization, 2011.