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, 89 (4), 454-64

Non-cigarette Tobacco Use Among Women and Adverse Pregnancy Outcomes


Non-cigarette Tobacco Use Among Women and Adverse Pregnancy Outcomes

Lucinda J England et al. Acta Obstet Gynecol Scand.


Although cigarette smoking remains the most prevalent form of tobacco use in girls and in women of reproductive age globally, use of non-cigarette forms of tobacco is prevalent or gaining in popularity in many parts of the world, especially in low- and middle-income countries. Sparse but growing evidence suggests that the use of some non-cigarette tobacco products during pregnancy increases the risk of adverse pregnancy outcomes. In this paper we review the literature on the prevalence of non-cigarette tobacco product use in pregnant women and in women of reproductive age in high-, middle-, and low-income countries and the evidence that maternal use of these products during pregnancy has adverse health effects. In addition, we communicate findings from an international group of perinatal and tobacco experts that was convened to establish research priorities concerning the use of non-cigarette tobacco products during pregnancy. The working group concluded that attempts to develop a public health response to non-cigarette tobacco use in women are hindered by a lack of data on the epidemiology of use in many parts of the world and by our limited understanding of the type and magnitude of the health effects of these products. We highlight research gaps and provide recommendations for a global research agenda.

Conflict of interest statement

Disclosure of interest: Ms. Kim, Ms. Ray, and Drs. England, Gupta, Eissenberg, Cnattingius, Bernert, Tita, Winn, Djordjevic, Lambe, Stamilio, Chipato, and Tolosa report no conflicts of interest. Dr. Tomar has served as an expert witness for plaintiffs in lawsuits brought against manufacturers of smokeless tobacco products and cigarettes. The findings and conclusions of this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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