Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors?

BACKGROUND: The widening socioeconomic gap in smoking during pregnancy remains a challenge to the Swedish antenatal care services. However, the influence of cultural factors in explaining the socioeconomic differences in smoking during pregnancy is not clear among the immigrant women. The aim of thi...

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Autores principales: Moussa, Kontie M, Ostergren, P-O, Eek, Frida, Kunst, Anton E
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906466/
https://www.ncbi.nlm.nih.gov/pubmed/20579380
http://dx.doi.org/10.1186/1471-2458-10-374
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author Moussa, Kontie M
Ostergren, P-O
Eek, Frida
Kunst, Anton E
author_facet Moussa, Kontie M
Ostergren, P-O
Eek, Frida
Kunst, Anton E
author_sort Moussa, Kontie M
collection PubMed
description BACKGROUND: The widening socioeconomic gap in smoking during pregnancy remains a challenge to the Swedish antenatal care services. However, the influence of cultural factors in explaining the socioeconomic differences in smoking during pregnancy is not clear among the immigrant women. The aim of this study was to investigate whether the development of smoking prevalence among pregnant immigrant women in Sweden followed the trajectory which could be expected from the stages of the global smoking epidemic model in the women's countries of origin, or not. METHODS: Delivery data on pregnancies in Sweden from 1982 to 2001 was collected from the Swedish Medical Birth Registry. From a total of 2,224,469 pregnant women during this period, all immigrant pregnant women (n = 234,731) were selected to this study. A logistic regression analysis and attributable fraction were used to investigate the association between smoking during pregnancy and the socioeconomic differences among immigrant women. RESULTS: Overall, the prevalence of smoking among pregnant immigrant women decreased from 30.3% in 1982 to 11.0% in 2001, albeit with remarkable differences between educational levels and country of origin. The greatest decline of absolute prevalence was recorded among low educated women (27,9%) and among other Nordic countries (17,9%). In relative terms, smoking inequalities increased between educational levels regardless of country of origin. The odds ratios for low educational level for women from other Nordic countries increased from 4.9 (95% CI 4.4-5.4) in 1982 to 13.4 (95% CI 11.2-16.2) in 2001, as compared to women with high education in the same group. Further, the total attributable fraction for educational difference increased from 55% in 1982 to 62% in 2001, demonstrating the strong effect of educational attainment. CONCLUSIONS: Our hypothesis that the socioeconomic time trend of smoking based on the stage of the world wide tobacco epidemic model related to country of origin of the immigrant women was not supported by our analyses. Our findings does not support a call for specific "culture sensitive" antismoking policies or interventions in Sweden or similar countries, but reinforce the existing evidence with a focus on women with a low educational level, regardless of cultural background.
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spelling pubmed-29064662010-07-20 Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors? Moussa, Kontie M Ostergren, P-O Eek, Frida Kunst, Anton E BMC Public Health Research Article BACKGROUND: The widening socioeconomic gap in smoking during pregnancy remains a challenge to the Swedish antenatal care services. However, the influence of cultural factors in explaining the socioeconomic differences in smoking during pregnancy is not clear among the immigrant women. The aim of this study was to investigate whether the development of smoking prevalence among pregnant immigrant women in Sweden followed the trajectory which could be expected from the stages of the global smoking epidemic model in the women's countries of origin, or not. METHODS: Delivery data on pregnancies in Sweden from 1982 to 2001 was collected from the Swedish Medical Birth Registry. From a total of 2,224,469 pregnant women during this period, all immigrant pregnant women (n = 234,731) were selected to this study. A logistic regression analysis and attributable fraction were used to investigate the association between smoking during pregnancy and the socioeconomic differences among immigrant women. RESULTS: Overall, the prevalence of smoking among pregnant immigrant women decreased from 30.3% in 1982 to 11.0% in 2001, albeit with remarkable differences between educational levels and country of origin. The greatest decline of absolute prevalence was recorded among low educated women (27,9%) and among other Nordic countries (17,9%). In relative terms, smoking inequalities increased between educational levels regardless of country of origin. The odds ratios for low educational level for women from other Nordic countries increased from 4.9 (95% CI 4.4-5.4) in 1982 to 13.4 (95% CI 11.2-16.2) in 2001, as compared to women with high education in the same group. Further, the total attributable fraction for educational difference increased from 55% in 1982 to 62% in 2001, demonstrating the strong effect of educational attainment. CONCLUSIONS: Our hypothesis that the socioeconomic time trend of smoking based on the stage of the world wide tobacco epidemic model related to country of origin of the immigrant women was not supported by our analyses. Our findings does not support a call for specific "culture sensitive" antismoking policies or interventions in Sweden or similar countries, but reinforce the existing evidence with a focus on women with a low educational level, regardless of cultural background. BioMed Central 2010-06-26 /pmc/articles/PMC2906466/ /pubmed/20579380 http://dx.doi.org/10.1186/1471-2458-10-374 Text en Copyright ©2010 Moussa et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Moussa, Kontie M
Ostergren, P-O
Eek, Frida
Kunst, Anton E
Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors?
title Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors?
title_full Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors?
title_fullStr Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors?
title_full_unstemmed Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors?
title_short Are time-trends of smoking among pregnant immigrant women in Sweden determined by cultural or socioeconomic factors?
title_sort are time-trends of smoking among pregnant immigrant women in sweden determined by cultural or socioeconomic factors?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906466/
https://www.ncbi.nlm.nih.gov/pubmed/20579380
http://dx.doi.org/10.1186/1471-2458-10-374
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