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OBJECTIVES: Our aim was to assess the use of dual/poly tobacco in a sample of pregnant women. DESIGN: cross-sectional survey. METHODS: Twenty prenatal care units in Botucatu, Sao Paulo, Brazil. We evaluated 127 high-risk pregnant smokers during prenatal care. Those who were 12-38 weeks pregnant and were currently smoking conventional cigarettes. The study enrollment took place between January 2015 and December 2015. The dual/poly prevalence of tobacco products during pregnancy and the characteristics related to smoking in pregnant smokers through a specific questionnaire containing questions related to sociodemographic characteristics, comorbidities, gestational history, smoking history, secondhand smoke exposure, nicotine dependence, motivation stage and use of alternative forms of tobacco. RESULTS: Mean age was 26.9 ± 6.6 years, most had only elementary education and belonged to lower income economic groups. Twenty-five (19.7%) smoked conventional cigarettes only while 102 used conventional and alternative forms of tobacco products. Smoking pack-years was significantly lower in those only smoking conventional cigarettes than in dual/poly users. Proportion of patients with elevated degree of nicotine dependence was higher in conventional cigarettes users. On the other side, alcohol intake was higher in dual/poly smokers when compared to conventional cigarettes group. The alternative forms of smoking were associated with significantly higher occurrences of comorbidities as pulmonary, cardiovascular and cancer. CONCLUSIONS FOR PRACTICE: The prevalence of alternative forms users of smoking products is high during pregnancy. These data reinforce the importance of a family approach towards smoking in pregnant women and education about the risks of alternative forms of tobacco.

What is Already Known? Studies show that the prevalence of pregnant women who consume alternative forms of tobacco is high, and that these types of smoking are also harmful to pregnancy.What this Study Adds? Our study describes the characteristics related to smoking in pregnant smokers and identifies dual/poly use of tobacco products.

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The effects of tobacco smoke, mild/moderate COPD disease and their combined effect on health status (HS), body composition (BC), and exercise capacity (EC) impairment are still unclear. We hypothesized that smoking and early COPD have a joint negative influence on these outcomes. We evaluated 32 smokers (smoking history >10 pack/years), 32 mild/moderate COPD (current smokers or former smokers), and 32 never smokers. All individuals underwent medical and smoking status evaluations, pre and post-bronchodilator spirometry, BC [fat-free mass (FFM) and FFM index (FFMI)], EC [six-minute walk distance (6MWD)] and HS [Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)]. FFM (p = 0.02) and FFMI (p = 0.008) were lower in COPD than never smokers. 6MWT, as a percentage of reference values for the Brazilian population, was lower in COPD and smokers than never smokers (p = 0.01). Smokers showed worse SF-36 score for functional capacity than never smokers (p<0.001). SF-36 score for physical functioning (p<0.001) and role-emotional (p<0.001) were impaired in COPD patients than smokers. SF-36 scores for physical functioning (p<0.001), role-physical (p = 0.01), bodily pain (p = 0.01), vitality (p = 0.04) and role-emotional (p<0.001) were lower in COPD than never smokers. Multiple linear regression analysis showed that both COPD diagnosis and smoking were inversely associated with FFMI, 6MWD and HS. Smoking and early COPD have a joint negative influence on body composition, exercise capacity and health status.

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OBJECTIVE: To examine the pattern of tobacco use and knowledge about tobacco-related diseases, as well as to identify popular types of electronic media, in pregnant women, in order to improve strategies for the prevention or cessation of smoking among such women. METHODS: A cross-sectional study involving 61 pregnant women, seen at primary care clinics and at a university hospital, in the city of Botucatu, Brazil. For all subjects, we applied the Hospital Anxiety and Depression Scale. For subjects with a history of smoking, we also applied the Fagerström Test for Nicotine Dependence, and we evaluated the level of motivation to quit smoking among the current smokers. RESULTS: Of the 61 pregnant women evaluated, 25 (40.9%) were smokers (mean age, 26.4 ± 7.4 years), 24 (39.3%) were former smokers (26.4 ± 8.3 years), and 12 (19.8%) were never-smokers (25.1 ± 7.2 years). Thirty-nine women (63.9%) reported exposure to passive smoking. Of the 49 smokers/former smokers, 13 (26.5%) were aware of the pulmonary consequences of smoking; only 2 (4.1%) were aware of the cardiovascular risks; 23 (46.9%) believed that smoking does not harm the fetus or newborn infant; 21 (42.9%) drank alcohol during pregnancy; 18 (36.7%) reported increased cigarette consumption when drinking; 25 (51.0%) had smoked flavored cigarettes; and 12 (24.5%) had smoked a narghile. Among the 61 pregnant women evaluated, television was the most widely available and favorite form of electronic media (in 85.2%), as well as being the form most preferred (by 49.2%). CONCLUSIONS: Among pregnant women, active smoking, passive smoking, and alternative forms of tobacco consumption appear to be highly prevalent, and such women seem to possess little knowledge about the consequences of tobacco use. Educational programs that include information about the consequences of all forms of tobacco use, employing new and effective formats tailored to this particular population, should be developed, in order to promote smoking prevention and cessation among pregnant women. Further samples to explore regional and cultural adaptations should be evaluated.

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OBJECTIVE: To examine the pattern of tobacco use and knowledge about tobacco-related diseases, as well as to identify popular types of electronic media, in pregnant women, in order to improve strategies for the prevention or cessation of smoking among such women. METHODS: A cross-sectional study involving 61 pregnant women, seen at primary care clinics and at a university hospital, in the city of Botucatu, Brazil. For all subjects, we applied the Hospital Anxiety and Depression Scale. For subjects with a history of smoking, we also applied the Fagerström Test for Nicotine Dependence, and we evaluated the level of motivation to quit smoking among the current smokers. RESULTS: Of the 61 pregnant women evaluated, 25 (40.9%) were smokers (mean age, 26.4 ± 7.4 years), 24 (39.3%) were former smokers (26.4 ± 8.3 years), and 12 (19.8%) were never-smokers (25.1 ± 7.2 years). Thirty-nine women (63.9%) reported exposure to passive smoking. Of the 49 smokers/former smokers, 13 (26.5%) were aware of the pulmonary consequences of smoking; only 2 (4.1%) were aware of the cardiovascular risks; 23 (46.9%) believed that smoking does not harm the fetus or newborn infant; 21 (42.9%) drank alcohol during pregnancy; 18 (36.7%) reported increased cigarette consumption when drinking; 25 (51.0%) had smoked flavored cigarettes; and 12 (24.5%) had smoked a narghile. Among the 61 pregnant women evaluated, television was the most widely available and favorite form of electronic media (in 85.2%), as well as being the form most preferred (by 49.2%). CONCLUSIONS: Among pregnant women, active smoking, passive smoking, and alternative forms of tobacco consumption appear to be highly prevalent, and such women seem to possess little knowledge about the consequences of tobacco use. Educational programs that include information about the consequences of all forms of tobacco use, employing new and effective formats tailored to this particular population, should be developed, ...

OBJETIVO: Examinar o padrão de consumo do tabaco e conhecimentos sobre as doenças relacionadas ao tabaco, assim como identificar os tipos mais populares de mídias entre gestantes para aprimorar estratégias para a prevenção e a cessação do tabagismo entre essas mulheres. MÉTODOS: Estudo transversal com 61 gestantes atendidas em um hospital universitário e em unidades básicas de saúde em Botucatu, SP. A Escala Hospitalar de Ansiedade e Depressão foi aplicada a todas as participantes. Para aquelas com história de tabagismo, também foi aplicado o Teste de Fagerström para Dependência de Nicotina, e foi avaliado o grau de motivação para cessação tabágica nas fumantes. RESULTADOS: Das 61 gestantes avaliadas, 25 (40,9%) eram fumantes (média de idade, 26,4 ± 7,4 anos), 24 (39,3%) eram ex-fumantes (média de idade, 26,4 ± 8,3 anos), e 12 (19,8%) nunca fumaram (média de idade, 25,1 ± 7,2 anos). A exposição passiva foi relatada por 39 gestantes (63,9%). Das 49 fumantes/ex-fumantes, 13 (29,6%) conheciam as consequências pulmonares do tabagismo; somente 2 (4,9%) conheciam os riscos cardiovasculares; 23 (46,9%) acreditavam que fumar não causa nenhum problema para o feto ou o recém-nascido; 21 (42,9%) consumiram álcool durante a gestação; 18 (36,7%) relataram aumento no consumo de cigarros quando bebiam; 25 (51,0%) experimentaram cigarros com sabores; e 12 (24,5%) fumaram narguilé. Entre as 61 gestantes avaliadas, a televisão foi o tipo de mídia mais disponível e favorita (85,2%), assim como a mais preferida (49,2%). CONCLUSÕES: Entre gestantes, o fumo ativo, o fumo passivo e o uso de formas alternativas de consumo de tabaco parecem ser altamente prevalentes, e tais mulheres parecem possuir poucos conhecimentos sobre as consequências do uso de tabaco. Programas educacionais que incluam informações sobre as consequências de todas as formas de uso de tabaco, utilizando formatos novos e efetivos para esta população específica, devem ser desenvolvidos para ...

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Identificar as características e os conhecimentos relacionados ao tabagismo de adolescentes e as mídias eletrônicas mais utilizadas por este grupo. Estudo de característica exploratória onde foram realizadas entrevistas com 60 adolescentes, fumantes, ex-fumantes ou não-fumantes por meio de protocolo de entrevista específico com questões relacionadas ao tabagismo. Além do questionário, a intensidade da dependência foi avaliada por meio do teste de Fagerstrõm, as fases de motivação pelo modelo de Prochaska e DiClemente e os sintomas sugestivos de ansiedade e depressão pela Escala Hospitalar de Ansiedade e Depressão de Zigmond e Snaith. A idade média dos adolescentes era de 15,8 ± 1,1 anos, 65% eram do sexo feminino, 41,7% fumantes ativos (60% meninas) e 28,3% ex-fumantes. Os adolescentes freqüentavam o ensino médio com 46,7% no primeiro ano. A maioria (73,8%) dos adolescentes fumantes e ex-fumantes iniciou o tabagismo com idades entre 14 e 16 anos e 26,2% entre 10 e 13 anos. O narguilé é popular entre os adolescentes tanto que 81% dos fumantes e ex-fumantes tiveram alguma experiência com esta forma de consumo do tabaco, desde a experimentação até o uso corrente. Entre os adolescentes que acreditavam que as pessoas começam a fumar por prestígio relacionado ao cigarro, 75% eram fumantes e daqueles que relataram que começam a fumar por influência dos pais e parentes, 83,3% eram fumantes. Os malefícios cardiovasculares foram identificados por apenas 5% dos adolescentes e, além disso, proporção considerável (20%) associa o tabagismo a algum “benefício”. A internet pelo computador (58,3%) é a mídia eletrônica mais utilizada para se divertir pelos adolescentes. Os conhecimentos dos adolescentes sobre tabagismo, sobre o uso de formas alternativas de tabaco e sobre dependência química da nicotina não são uniformes ou completos e, algumas vezes, equivocados...

Identify the characteristics and knowledge related to adolescents tabagism and the electronic media most used by this group. Exploratory study with interviews were done with 60 adolescents, smokers, ex-smokers or none smokers through specific interview approach with issues related to tabagism. In addition to questionnaire, the intensity of dependence was assessed through Fagerstrõm test, motivation stages through Prochaska and DeClemente model and the suggested anxiety and depression symptoms by the hospital anxiety and depression scale of Zigmond & Snaith. The adolescent average age was 15,8 ± 1,1 years, 65% were female, 41,7% active smokers (60% girls) and 28,3% ex-smokers. The adolescents used to be in high school with 46,7% during their first year. Most of the adolescent smokers and ex-smokers (73,8%) started tabagism with ages between 14 and 16 years and 26,2 % between 10 and 13 years. Hookah smoking is popular between the adolescents to the extent that 81% of the smokers and ex-smokers had some experience with this form of tobacco consumption from tasting to current use. Between adolescents that believe that people start to smoke to show off with relation to cigarette 75% were smokers and between that believe that people start to smoke to parental influence 83,3% were smoker. The cardiac negative effect were identified by just 5% the kids and, in addiction, considerable proportion (20%) connect tabagism with some “benefits”. The internet through computers (58,3%) is an electronic media more used to have fun by the kids. The knowledge of adolescents on tabagism, non conventional way of tobacco and nicotine chemical dependence are not standardized or complete and, sometimes controversial. With respect to the result of this trial, is necessary to develop content coverage that by pass the errors of the knowledge on adolescents about tabagism, using internet tool as preference...

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