Exposure to Second-hand Smoke and Having Regular Family Physicians Are Associated With Cessation of Smoking During Pregnancy: A Population-based Study

Background:The association of second-hand smoke with prenatal smoking cessation is less studied, and so is the family physician's role in prenatal smoking cessation. We examined the association between second-hand smoke during pregnancy and having a regular family physician with prenatal smoking cessation in a representative sample of Canadian households.Method:We used the data from Canadian Community Health Surveys (CCHS), 2017-2018, with a sample of 838 women who reported regular (every day) smoking within the 3 months before knowing their last pregnancy. The outcome variable was dichotomized as cessation or continuation of smoking during pregnancy. We used multivariable logistic regression, adjusted for socio-demographic variables, to examine the association of smoking cessation during pregnancy with second-hand smoke and having a regular family physician.Results:Overall, 33.9% (95% confidence interval, 30.0%, 39.2%) of women who were regular smokers before pregnancy reported quitting smoking during pregnancy. The smoking cessation rate was 17.6% (95% CI 11.8, 25.4) among women who had exposure to second-hand smoke and 38.1% (95% CI 32.1, 44.5) women who had a regular family physician. When adjusted for maternal age, maternal education, total household income, and indigenous status, exposure to second-hand smoke was associated with lower odds of smoking cessation during pregnancy, adjusted odds ratios (aOR) of 0.22 (95% CI: 0.12, 0.41) and having a regular family physician was associated with higher odds of quitting smoking [aOR 2.67 (95% CI: 1.23, 5.79)].Conclusion:Smoking cessation during pregnancy was negatively associated with ongoing exposure to second-hand smoke and was positively associated with having a regular family physician. Contexte:L'association entre l'exposition a la fumee secondaire et le renoncement au tabac pendant la grossesse est moins etudiee, tout comme le role du medecin de famille dans le renoncement au tabac pendant la grossesse. Nous avons examine l'association entre la fumee secondaire pendant la grossesse et le fait d'avoir un medecin de famille regulier et l'abandon du tabagisme prenatal dans un echantillon representatif de menages canadiens.Methode:Nous avons utilise les donnees des enquetes sur la sante dans les collectivites canadiennes (ESCC), 2017-2018, avec un echantillon de 838 femmes qui ont declare avoir fume regulierement (tous les jours) au cours des trois mois avant de connaitre leur derniere grossesse. La variable de resultat a ete divisee en cessation ou poursuite du tabagisme pendant la grossesse. Nous avons utilise une regression logistique multivariable, ajustee sur les variables sociodemographiques, pour examiner l'association de l'arret du tabac pendant la grossesse avec l'exposition a la fumee secondaire et le fait d'avoir un medecin de famille regulier.Resultats:Dans l'ensemble, 33.9% (intervalle de confiance a 95%, 30.0%, 39.2%) des femmes qui fumaient regulierement avant la grossesse ont declare avoir cesse de fumer pendant la grossesse. Le taux d'abandon du tabac etait de 17.6% (IC 95% 11.8, 25.4) chez les femmes exposees a la fumee secondaire et de 38.1% (IC 95% 32.1, 44.5) chez les femmes qui avaient un medecin de famille regulier. Apres ajustement en fonction de l'age maternel, du niveau d'education de la mere, du revenu total du menage et du statut d'autochtone, l'exposition a la fumee secondaire etait associee a une probabilite plus faible d'arret du tabac pendant la grossesse, rapport de cotes ajuste (RCA) de 0.22 (IC a 95%: 0.12, 0.41), et le fait d'avoir un medecin de famille regulier etait associe a une probabilite plus elevee d'arret du tabac [RCA de 2.67 (IC a 95% : 1.23, 5.79)].Conclusion:L'arret du tabac pendant la grossesse est negativement associe a l'exposition continue a la fumee secondaire et positivement associe au fait d'avoir un medecin de famille regulier.