Avoidance of environmental tobacco smoke among non-smoking pregnant women in Malaysia

Background: This study aimed to examine the association between environmental tobacco smoke (ETS) and avoidance of tobacco smoke among pregnant non-smoking women.

Methods: A cross-sectional study was used to obtain a representative sample of non-smoking pregnant women who attended health clinics (n = 661) six states in Malaysia. The durations of ETS exposure within and outside of the home were obtained by self-report. Exposure to ETS was assessed by the second-hand smoke (SHS) avoidance subscale. The analyses were conducted using logistic regression adjusted for demographic variables and other variables.

Results: Among non-smoking pregnant women, the prevalence of ETS exposure was 66.3%. The overall knowledge of ETS was good (>50%). The odds of ETS exposure were higher among those in the low-salary (RM1000-RM1999) group (OR=2.37; 95% CI=1.22, 4.62) and those with a history of chronic disease (OR=2.47; 95% CI=1.09, 5.62), whereas ETS exposure was significantly lower among those working full time during pregnancy (OR=0.31; 95% CI=0.17, 0.59). In the multivariate model, compared with non-ETS-exposed individuals, ETS-exposed individuals showed significantly different avoidance behaviour in situations that involved speaking to smokers who were smoking in same room (OR=2.31; 95%CI= 1.26, 4.21), sitting in a smoking section on public transport (OR=2.15; 95% CI= 1.07, 4.34) and frequently associating with smokers (OR=3.01; 95% CI=1.14-8.30).

Conclusions: Our findings revealed that knowledge about ETS exposure failed to manifest as avoidance behaviour. The knowledge was good but avoidance was poor, especially among women frequently exposed to ETS.