Elsevier

Preventive Medicine

Volume 32, Issue 4, April 2001, Pages 313-320
Preventive Medicine

Regular Article
Smoking Status, Reading Level, and Knowledge of Tobacco Effects among Low-Income Pregnant Women

https://doi.org/10.1006/pmed.2000.0815Get rights and content

Abstract

Background. Smoking during pregnancy increases the health risks of the unborn child as well as the mother. Although smoking rates for the population as a whole have declined drastically in the past generation, since 1992 there has been an increase in smoking among women, teenagers, and adults living in poverty. The purpose of this study was to assess reading level, tobacco knowledge, attitudes, and practices of tobacco use among pregnant adult and adolescent women in the public health system in north Louisiana.

Methods. A convenience sample of 600 pregnant women was interviewed in person in the Obstetrics Clinics at Louisiana State University Health Sciences Center at Shreveport and E.A. Conway in Monroe. The structured interview contained detailed questions about smoking practices, tobacco knowledge, and attitudes. Reading was assessed using the Rapid Estimate of Adult Literacy in Medicine. Smoking practices were assessed by self-report and verified by measuring urine cotinine levels. The Cochran-Mantel-Haenszel test was used to estimate the relationship between reading level and knowledge and attitude; multiple logistic regression was used to determine which variable(s) predicted current smoking practices.

Results. Knowledge about the effects of smoking and concern about the health effect of smoking on their baby varied significantly by reading level, with participants with higher reading levels having more knowledge and greater concern. Smoking practices did not vary by reading level even when race, age, and living with a smoker were controlled. Race was a significant determinant of smoking practices, with more white women reporting currently smoking during pregnancy than African Americans (34% vs 8%).

Conclusions. Reading level was related to knowledge about health effects of smoking. Women with higher reading levels were also more concerned about the adverse health effects of smoking on themselves and their babies. However, reading level was not correlated with smoking prevalence. The most significant determinant of smoking was race (with whites smoking significantly more than African Americans).

References (31)

  • A Valbo et al.

    Smoking in pregnancy: a follow up study of women unwilling to quit

    Addict Behav

    (1993)
  • TC Davis et al.

    Tobacco use among male high school athletes

    J Adolesc Health

    (1997)
  • MV Williams et al.

    Inadequate literacy is a barrier to asthma knowledge and self-care

    Chest

    (1998)
  • E Lieberman et al.

    Low birth weight at term and the timing of fetal exposure to maternal smoking

    Am J Public Health

    (1994)
  • J Kleinman et al.

    The effects of maternal smoking, physical stature, and educational attainment on the incidence of low birth weight

    Am J Epidemiol

    (1985)
  • I McIntosh

    Smoking and pregnancy: II. Offspring risk

    Public Health Rev

    (1984)
  • UJ Oyemade

    Prenatal substance abuse and pregnancy outcomes among African American women

    J Nutr

    (1994;Jun)
  • J Cunningham et al.

    Racial differences in the association between maternal smoking during pregnancy and lung function in children

    Am J Respir Care Med

    (1995)
  • Healthy People 2000: National health promotion and disease prevention objectives, summary report, Washington: U.S....
  • A Kahn

    Prenatal exposure to cigarettes in infants with obstructive sleep apneas

    Pediatrics

    (1994)
  • G Flipinni et al.

    Mothers' active and passive smoking during pregnancy and risk of brain tumors in children

    Int J Cancer

    (1994)
  • RL Naeye

    Influence of maternal cigarette smoking during pregnancy on fetal and childhood growth

    Obstet Gynecol

    (1989)
  • P Cotton

    Smoking cigarettes may do developing fetus more harm than injecting cocaine, some experts say

    JAMA

    (1994)
  • Am J Respir Crit Care Med

    (1996)
  • AT Geronimus et al.

    Age patterns of smoking in US black and white women of childbearing age

    Am J Public Health

    (1993)
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    This research was funded by the Louisiana Cancer and Lung Trust Fund, Grant 95-01-02, “Tobacco Beliefs and Practices in Low-Income Pregnant Women.”

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    To whom correspondence and reprint requests should be addressed at Department of Medicine, Louisiana State University Health Sciences Center-Shreveport, 1501 Kings Highway, P.O. Box 33932, Shreveport, LA 71130-3932. Fax: (318) 675-4319. E-mail: [email protected].

    3

    Dr. Nandy is now at Clintrials Research, Inc.

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