Secondhand smoking exposure and quality of life among pregnant and postnatal women: a network approach
Meng Zhang,
Yuan Yang,
Gabor S Ungvari,
Yu-Tao Xiang,
Yang Xu,
Li-rong Meng,
Dong-ying Zhang,
Hai-Xin Bo,
Liang-Kun Ma,
Pei-Hong Wang,
Xiao-Hua Liu,
Li-Na Ge,
Wen-Xuan Lin,
Ya-Lan Zhang,
Feng-Juan Li,
Xu-Juan Xu,
Hong-He Wu,
Todd Jackson,
Teris Cheung
Affiliations
Meng Zhang
Department of Obstetrics, Chinese Academy of Medical Sciences, Peking Union Medical College, Peking Union Medical College Hospital, Beijing, Beijing, China
Yuan Yang
Guangdong Mental Health Center, Guangdong Provincial People`s Hospital (Guangdong Academy of Medical Sciences), Guangzhou, Guangdong, China
Gabor S Ungvari
Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Western Australia, Australia
Yu-Tao Xiang
Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, Macau, China
Yang Xu
Department of Obstetrics, China-Japan Friendship Hospital, Beijing, Beijing, China
Li-rong Meng
School of Health Sciences, Macau Polytechnic Institute, Macao SAR, Macau, China
Dong-ying Zhang
Department of Obstetrics, Chinese Academy of Medical Sciences, Peking Union Medical College, Peking Union Medical College Hospital, Beijing, Beijing, China
Hai-Xin Bo
Department of Nursing, Chinese Academy of Medical Sciences, Peking Union Medical College, Peking Union Medical College Hospital, Beijing, Beijing, China
Liang-Kun Ma
Department of Obstetrics, Chinese Academy of Medical Sciences, Peking Union Medical College, Peking Union Medical College Hospital, Beijing, Beijing, China
Pei-Hong Wang
Department of Obstetrics, Xiehe Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
Xiao-Hua Liu
Department of Obstetrics, Shuangliu District Maternal and Child Health Hospital, Chengdu, Sichuan, China
Li-Na Ge
Department of Obstetrics, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China
Wen-Xuan Lin
Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
Ya-Lan Zhang
Department of Obstetrics, Qinghai Provincial People`s Hospital, Xining, Qinghai, China
Feng-Juan Li
Department of Obstetrics, Maternal and Child Health Care Hospital of Uygur Autonomous Region, Urumqi, Xinjiang, China
Xu-Juan Xu
Department of Obstetrics, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
Hong-He Wu
Department of Obstetrics, Nantong Maternity and Child Health Care Hospital, Nantong, Jiangsu, China
Todd Jackson
Department of Psychology, University of Macau, Macao SAR, Macau, China
Teris Cheung
School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong, China
Objective This study examined the prevalence of exposure to secondhand smoke, its correlates and its association with quality of life (QOL) among pregnant and postnatal Chinese women.Design This was a multicentre, cross-sectional study.Setting Participants were consecutively recruited from eight tertiary hospitals located in eight municipalities or provinces in China.Participants A total of 1140 women were invited to join this study and 992 (87.02%) completed all measures.Primary and secondary outcome Measures women’s secondhand smoking behaviour (frequency and location of exposure to secondhand smoking), and their QOL measured by the WHO Quality of Life Questionnaire.Results A total of 211 women (21.3%, 95% CI 18.7% to 23.8%) had been exposed to secondhand smoking. Exposure to secondhand smoking was most common in public areas (56.4%), and residential homes (20.5%), while workplaces had the lowest rate of exposure (13.7%). Women with physical comorbidities were more likely to report secondhand smoking exposure, while older women, women living in urban areas, those with college or higher education level, and women in their second trimester were less likely to report exposure to secondhand smoking. Network analysis revealed that there were six significant links between secondhand smoke and QOL items. The strongest negative edge was the connection between secondhand smoke and QOL9 (‘physical environment health’, edge weight=−0.060), while the strongest positive edge was the connection between secondhand smoke and QOL3 (‘pain and discomfort’, edge weight=0.037).Conclusion The prevalence of exposure to secondhand smoking is becoming lower among pregnant and postnatal women in China compared with findings reported in previous studies. Legal legislation should be maintained and promptly enforced to establish smoke-free environments in both public and private urban/rural areas for protection of pregnant and postnatal women, especially those who are physically vulnerable and less educated.
