SMOKING CESSATION IN PREGNANCY IN UKRAINE

Tatiana I. Andreeva, Ganna V. Dovbakh, Konstantin S. Krasovsky, Tetyana O. Salyuk

Alcohol and Drug Information Center (ADIC-Ukraine)
CONTEXT. The problem of smoking in pregnancy in countries like Ukraine is complicated by lack of intervention skills for smoking cessation among health professionals.
OBJECTIVE: to determine factors influencing smoking cessation and to develop recommendations to increase cessation rates.

SETTING: a survey of an unselected area-based sample of 698 women attending prenatal care clinics in Kiev, Ukraine in 2003, aged 14-40. Women were asked about reproductive health, family, alcohol, tobacco, coffee use, counseling on tobacco issues, knowledge about tobacco related health impact.

MAIN OUTCOME MEASURE: smoking status of a pregnant woman at interview time. RESULTS. Five groups of smoking status were determined: 60% nonsmokers, 35.4% former smokers, 2.6% regular smokers trying to quit and 2.0% regular smokers not motivated to quit. Alcohol and coffee consumption in the family complicate the process of smoking cessation. Chances for smoking cessation decreased when baby’s father didn’t live together with pregnant woman (OR=0,186, 95% CI 0,042-0,826), was a smoker (OR=0,172, 95% CI 0,045-0,666), woman was exposed to ETS (OR=0,300, 95% CI 0,120-0,752), reported own alcohol consumption (OR=0,339, 95% CI 0,149-0,775), larger number of induced abortions (OR=0,656 per each abortion, 95% CI 0,477-0,902). Knowledge of smoking related harm (OR=0,361, 95% CI 0,132-0,985) was less important for smoking cessation than emotional attitude to possible outcome (OR=3,106, 95% CI 1,054-9,159).

CONCLUSIONS. Family factors and other substances use are important for smoking cessation in pregnancy in Ukraine, and need to be taken into account when counseling pregnant women on smoking cessation. Information about ETS impact is essential, substance abuse by family members as well.

FUNDING INFORMATION. This survey was supported by the World Bank and UNICEF.