Maternal use of cigarettes, pipes, and smokeless tobacco associated with higher infant mortality rates in Cambodia

Asia Pac J Public Health. 2013 Sep;25(5 Suppl):64S-74S. doi: 10.1177/1010539513493458.


In the Western Pacific Region, rural women use loose tobacco in betel quid chewing and pipe smoking. We examined the relation between maternal use of tobacco and infant mortality (IM) in a national sample of 24 296 birth outcomes in adult women (n = 6013) in Cambodia. We found that (1) age-adjusted odds of IM were higher for maternal use of any tobacco (odds ratio [OR] = 1.69; 95% confidence interval [CI] = 1.27-2.26); (2) age-adjusted odds of IM were higher for cigarette use (OR = 2.54; 95% CI = 1.54- 4.1), use of pipes (OR = 3.09; [95% CI = 1.86-5.11]), and betel quid chewing (OR = 1.55; 95% CI = 1.10-2.17); and (3) these associations remained after multivariable adjustment for environmental tobacco smoke, malnutrition, ethnicity, religion, marital status, education, income, occupation, and urban/rural dwelling. In addition to finding the established association with cigarettes, we also found that maternal use of smokeless tobacco and pipes was associated with higher rates of infant death in Cambodia.

Keywords: family medicine; global health; maternal and child health; public health; smoking/tobacco/drug abuse; water pipe; women’s health.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Cambodia / epidemiology
  • Female
  • Health Surveys
  • Humans
  • Infant
  • Infant Mortality / trends*
  • Middle Aged
  • Pregnancy
  • Risk Assessment
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Socioeconomic Factors
  • Tobacco, Smokeless / adverse effects*
  • Tobacco, Smokeless / statistics & numerical data
  • Young Adult