{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T20:25:41Z","timestamp":1748377541460,"version":"3.41.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Monitoring tobacco use during pregnancy is critical for achieving the United Nations Sustainable Development Goals. We examined changes between 2013 and 2019 in the relative differences in smoking prevalence rates between pregnant and nonpregnant women aged 18\u201349 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims and Methods<\/jats:title>\n                  <jats:p>We used data from a nationally representative health survey conducted in Brazil in 2013 and 2019. A generalized linear model with binomial family and logarithmic link function was used to estimate, for each year of analysis, the crude and adjusted (by age group, educational attainment, place of residence, and status of protection from passive smoking at home) relative differences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 2013, the proportion point estimate of tobacco use among pregnant women was lower than that observed among nonpregnant women (4.7% vs. 9.6%). However, in 2019 proportion point estimates were virtually the same (8.5% vs. 8.4%). After adjustment for selected variables, in 2013, smoking prevalence among pregnant women was 42% (p-value\u2005\u2264\u2005.05) lower than that observed among nonpregnant women. On the other hand, in 2019, maternal smoking prevalence was 13% (p-value\u2005&amp;gt;\u2005.05) higher than that found among nonpregnant women.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Ongoing tobacco industry interference and the marketing of tobacco products to vulnerable populations pose serious threats to public health and likely contribute to increasing maternal smoking prevalence. The fact that women smoke in such an important phase of their and their unborn children\u2019s lives reinforces the need to strengthen the implementation of concurrent tobacco control actions, including tobacco excise tax policy and prenatal tobacco prevention and cessation interventions as part of health professionals\u2019 routine consultation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>The decline in smoking prevalence among nonpregnant women between 2013 and 2019 was accompanied by an increase in maternal smoking prevalence. Monitoring tobacco use during pregnancy is critical for achieving the United Nations Sustainable Development Goals. Ongoing tobacco industry interference and the marketing of tobacco products to vulnerable populations in Brazil pose serious threats to public health. The fact that women smoke in such an important phase of their and their unborn children\u2019s lives reinforces the need to strengthen the implementation of concurrent tobacco control actions, including tobacco excise tax policy and primary healthcare professionals\u00b4 tobacco-related assistance during interaction with their patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntae157","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T22:09:57Z","timestamp":1719353397000},"page":"1749-1753","source":"Crossref","is-referenced-by-count":1,"title":["Maternal Smoking Prevalence in Brazil in 2013 and 2019: Not What We Expected When They Were Expecting!"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1903-6188","authenticated-orcid":false,"given":"Andr\u00e9 Salem","family":"Szklo","sequence":"first","affiliation":[{"name":"Tobacco Control Unit, Coordination for Prevention and Surveillance, Brazilian National Cancer Institute (INCA) , Rio de Janeiro ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8377-4794","authenticated-orcid":false,"given":"Graziele","family":"Grilo","sequence":"additional","affiliation":[{"name":"Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Drope","sequence":"additional","affiliation":[{"name":"Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,26]]},"reference":[{"volume-title":"The health consequences of smoking - 50 years of progress: a report of the surgeon general","year":"2014","author":"United States Surgeon General. Department of Health and Human Services","key":"2025052602164167100_CIT0001"},{"year":"2024","author":"Pinto","key":"2025052602164167100_CIT0002"},{"volume-title":"Legisla\u00e7\u00e3o \u2013 por tema","author":"Instituto Nacional de C\u00e2ncer","key":"2025052602164167100_CIT0003"},{"issue":"5","key":"2025052602164167100_CIT0004","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1136\/tobaccocontrol-2015-052324","article-title":"Smokers in Brazil: who are they","volume":"25","author":"Szklo","year":"2016","journal-title":"Tob Control."},{"key":"2025052602164167100_CIT0005","doi-asserted-by":"crossref","first-page":"e00107421","DOI":"10.1590\/0102-311x00107421","article-title":"\u201cTobacco denormalization at home\u201d: the contribution of the smoking ban in enclosed workplaces in Brazil","volume":"38","author":"Szklo","year":"2022","journal-title":"Cad Saude Publica"},{"issue":"2","key":"2025052602164167100_CIT0006","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1136\/tobaccocontrol-2021-057007","article-title":"Achievements, challenges, priorities and needs to address the current tobacco epidemic in Latin America","volume":"31","author":"S\u00f3\u00f1ora","year":"2022","journal-title":"Tob Control."},{"volume-title":"Department of Economic and Social Affairs","author":"The United Nations","key":"2025052602164167100_CIT0007"},{"volume-title":"Pesquisa Nacional de Sa\u00fade, 2013: percep\u00e7\u00e3o do estado de sa\u00fade, estilos de vida e doen\u00e7as cr\u00f4nicas","year":"2014","author":"Instituto Brasileiro de Geografia e Estat\u00edstica","key":"2025052602164167100_CIT0008"},{"volume-title":"Pesquisa Nacional de Sa\u00fade, 2019: percep\u00e7\u00e3o do estado de sa\u00fade, estilos de vida, doen\u00e7as cr\u00f4nicas e sa\u00fade bucal","year":"2020","author":"Instituto Brasileiro de Geografia e Estat\u00edstica","key":"2025052602164167100_CIT0009"},{"issue":"6","key":"2025052602164167100_CIT0010","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1590\/1413-81232018236.06022018","article-title":"SUS: supply, access to and use of health services over the last 30 years","volume":"23","author":"Viacava","year":"2018","journal-title":"Cien Saude Colet"},{"issue":"7","key":"2025052602164167100_CIT0011","doi-asserted-by":"crossref","first-page":"e769","DOI":"10.1016\/S2214-109X(18)30223-7","article-title":"National, regional, and global prevalence of smoking during pregnancy in the general population: a systematic review and meta-analysis","volume":"6","author":"Lange","year":"2018","journal-title":"Lancet Glob Health."},{"issue":"11","key":"2025052602164167100_CIT0012","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1093\/ntr\/ntt073","article-title":"Smoking and adverse maternal and child health outcomes in Brazil","volume":"15","author":"Levy","year":"2013","journal-title":"Nicotine Tob Res."},{"issue":"1","key":"2025052602164167100_CIT0013","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1136\/tobaccocontrol-2020-056360","article-title":"\u201cIf I hadn\u2019t seen this picture, I\u2019d be smoking\u201d-perceptions about innovations in health warnings for cigarette packages in Brazil: a focus group study","volume":"32","author":"Perez","year":"2023","journal-title":"Tob Control."},{"volume-title":"Global Center for Good Governance in Tobacco Control (GGTC)","year":"2021","author":"Mary Assunta. Global Tobacco Industry Interference Index 2021","key":"2025052602164167100_CIT0014"},{"issue":"12","key":"2025052602164167100_CIT0015","doi-asserted-by":"crossref","first-page":"e00175420","DOI":"10.1590\/0102-311x00175420","article-title":"Interfer\u00eancia da ind\u00fastria do tabaco sobre os dados do consumo de cigarro no Brasil [Interference by the tobacco industry in data on cigarette consumption in Brazil]","volume":"36","author":"Szklo","year":"2020","journal-title":"Cad Saude Publica"},{"issue":"3","key":"2025052602164167100_CIT0016","doi-asserted-by":"crossref","first-page":"8","DOI":"10.53127\/tblg-2021-A020","article-title":"Electronic nicotine delivery systems in Brazil: to ban or not to ban, that\u2019s the question","volume":"19","author":"Szklo","year":"2021","journal-title":"Tabaccologia"},{"issue":"2","key":"2025052602164167100_CIT0017","doi-asserted-by":"crossref","first-page":"230","DOI":"10.2105\/AJPH.2020.305999","article-title":"E-cigarette use and adult cigarette smoking cessation: a meta-analysis","volume":"111","author":"Wang","year":"2021","journal-title":"Am J Public Health."},{"volume-title":"WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy","year":"2013","key":"2025052602164167100_CIT0018"},{"issue":"4","key":"2025052602164167100_CIT0019","doi-asserted-by":"crossref","first-page":"442","DOI":"10.3109\/00016341003678450","article-title":"Prenatal tobacco prevention and cessation interventions for women in low- and middle-income countries","volume":"89","author":"Oncken","year":"2010","journal-title":"Acta Obstet Gynecol Scand."},{"key":"2025052602164167100_CIT0020","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.puhe.2023.10.009","article-title":"Smokers who were seen by a doctor or other healthcare provider for any health concern in Brazil: what a missed opportunity to encourage smoking cessation!","volume":"225","author":"Szklo","year":"2023","journal-title":"Public Health."}],"container-title":["Nicotine and Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntae157\/58500497\/ntae157.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/26\/12\/1749\/59834609\/ntae157.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/26\/12\/1749\/59834609\/ntae157.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T06:16:55Z","timestamp":1748240215000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/article\/26\/12\/1749\/7699178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,26]]},"references-count":20,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,6,26]]},"published-print":{"date-parts":[[2024,11,22]]}},"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntae157","relation":{},"ISSN":["1469-994X"],"issn-type":[{"type":"electronic","value":"1469-994X"}],"subject":[],"published-other":{"date-parts":[[2024,12]]},"published":{"date-parts":[[2024,6,26]]}}}