Study Of Intervention On Passive Smoking Exposure Of Pregnant Women In One Shanghai District

ObjectiveThis study is to research the level and effect factors of second-hand smoking exposure of pregnant women in one of shanghai districts, to know their knowledge of health and second-hand smoking and attitude, to passive smoking, to evaluate the effect of intervention on passive smoking exposure level of pregnant women based on skills development.MethodsThe passive smoking situation of pregnant women is analyzed by cross-sectional study. The intervention effect is evaluated by randomized controlled trial with questionnaire survey. The study is conducted by following steps.6 communities with similar demographic structure in one Shanghai district were selected as target groups.3720 pregnant women registered between March 2011 and February 2012 in these communities participated in baseline and final survey by one-on-one interview. The questionnaire contented their demographical features, first-hand and second-hand smoking status and knowledge of second-hand smoking with their husbands involved in the survey.4 communities were divided into intervention groups, which the other 2 communities were selected as control groups. In intervention groups two times face-to-face guidance, two times video lessens in pregnant women school(with pregnant women and their husbands together), one time home visit, one time house call were conducted. The education contented detriment by second-hand smoking and skills of actively refusing passive smoking. In the control groups no special intervention activities were organized.ResultsAt the end 3700 pregnant women have participated in the baseline survey.25 of them were smokers. The survey result of rest 3675 pregnant women were analyzed, with 2301 women in intervention groups and 1374 women in control groups.3241 pregnant women have completed the final survey with 2151 women in intervention groups and 1090 in control groups.1.second-hand smoking exposure levelWithin 3675 non-smoking pregnant women 1486 women have exposure in passive smoking in 30 days after the baseline survey started. The total passive smoking rate was 40.4%, which in intervention groups it was 47.8% and in control groups it was 30.8%. The passive smoking rate at home was 18.4%, which at work places it was 12.4% and at public places was 26.1%.2.effect factors of second-hand smoking exposureIn the study it was found that Second-hand smoking exposure rate of pregnant women was related to age, average family income per person, education level, job position, on-the-job situation and childbearing history. To compared with younger women, the passive smoking rate of one year elder women was 7% lower (OR=0.93, 95%CI=0.9～0.96). The passive smoking rate of women with average monthly income below 3000 was 1.32 times to the women with average monthly income over 10000 (OR=1.32,95%CI=1.02-1.72). The passive smoking rate of women graduated from middle school or technical secondary school was 0.78 time to the women graduated from university and above (OR=0.78,95%CI= 0.65-0.94). This rate of women without jobs was 0.7 time to the women on the job (OR=0.7, 95%CI=0.58-0.84). The rate of women, the women with worker or service job positions, the women with technical or management job positions and the individual women households or temporary women workers,the women with other kinds of jobs, was respectively 1.16 time,1.29 time,1.34 time and 2.02 times to women without jobs(OR=1.16,95%CI=0.89-1.53;OR=1.29,95% CI=1.04-1.62; OR=1.34,95%CI=0.97-1.86;OR=2.02,95%CI=1.55-2.62). The rate of multipara was 0.73 time to primipara (OR=0.73,95%C/=0.59-0.92)3.Scores on second-hand smoking and health knowledge test and attitude to passive smokingIn the study it was found the average score of pregnant women on second-hand smoking and health knowledge test was only 58.4.99% pregnant women have wishes to avoid passive smoking.4.intervention effectThe score of intervention groups on baseline was 58.6, while it increased to 86.1 in final survey. The difference is significant (p<0.001). The score of control groups on baseline was 57.6, while it rose to 87.0 in final survey. The difference is significant.The passive smoking rate of intervention groups at home before intervention was 21.9%, in final survey it dropped to 3.2%. The difference is significant(p<0.001). The passive smoking rate of control groups at home on baseline was 12.0%, while the rate of control groups was 2.8% in final survey. The difference is significant (p<0.001). The passive smoking time at home of intervention and control groups in final survey in 30 days has both reduced. The difference is also significant.At work places, the passive smoking rate of intervention groups before intervention was 12.6%, while the rate at home dropped to 1.2% in final survey. The difference is significant (p<0.001). The passive smoking rate of control groups on baseline was 13.1%, while the rate of control groups was 1.1% in final survey. The difference is significant (p<0.001). The passive smoking time at work places of intervention and control groups in final survey in 30 days has both reduced. The difference is significant.At public places, the passive smoking rate of intervention groups before intervention was 29.1%, while the rate at home dropped to 5.0% in final survey. The difference is significant (p<0.001). The passive smoking rate of control groups on baseline was 18.0%, while the rate of control groups was 2.3% in final survey. The difference is significant (p<0.001). The passive smoking time at work places of intervention and control groups in final survey in 30 days has both reduced. The difference is significant.The result shows that the added score on second hand smoking and health of intervention groups in final survey has no significant difference with control groups in final survey (F=1.67, p=0.196). In final survey, the passive smoking rate of intervention group at home is half of control group (t=-2.75, p=0.006). The passive smoking time of intervention group is shorter than control group. The difference is significant(F= 11.41, p=0.0007). The passive smoking rate and time of intervention group at work places has no significant difference with that of control group (t=0.12, p=0.907, F= 0.4, p=0.5022). The passive smoking rate and time of intervention group at public places has no significant difference with that of control group(t=-1.23, p=0.218, F=0.02, p=0.8866).When we analyze the pregnant women less than 30 ages and as technical or administrative staff, the result shows that the passive smoking rate of intervention group at home has no significant difference with that of control group. The population median of decreased passive smoking time of intervention group is larger than that of control group. The difference is significant (z=2.122,p=0.034).In final survey, the population median of passive smoking rate and time reduction of intervention group at work places has no significant difference with that of control group(χ2＝1.745, p=0.186 and z=1.45,p=0.147). The population median of passive smoking time reduction of intervention group is larger than that of control group. The difference is significant (z=-2.521,p=0.012).ConclusionIt is effective to lower passive smoking exposure level of pregnant women at home by intervention. Intervention is hardly to reduce to the exposure level at work places and public places. Intervention with skills and knowledge education has limited effect. The traditional intervention mode needs to be changed. The skills of intervention target should be well educated and trained. Smoking prohibition in work places and public places should be strictly carried out. To build a smoking free environment, the law enforcement and supervision in smoking control need to be further enhanced.