261723 Examining the Impact of Smokefree Laws on Preterm Birth

Wednesday, October 31, 2012 : 11:26 AM - 11:43 AM

Kristin Ashford, PhD, APRN , College of Nursing, Univerisity of Kentucky, Lexington, KY
Joyce Robl, EdD(c), MS, CGC , Division of Maternal Child Health, Kentucky Department for Public Health, Frankfort, KY
Ruth Ann Shepherd, MD, FAAP , Division of Maternal Child Health, Kentucky Department for Public Health, Frankfort, KY
Andrea McCubbin, BA , College of Nursing, University of Kentucky, Lexington, KY
Introduction: Prenatal secondhand smoke exposure and smoking during pregnancy increase risk for preterm birth; however limited data exists on the impact of smoke-free communities on preterm birth (PTB). This paper describes the impact of smoke-free laws in Kentucky on low birth weight (LBW), PTB and smoking in the three months prior to pregnancy (PRIOR).

Methods: This study used Kentucky live birth certificate files from 2004 to 2009 in Kentucky counties/ cities with smoke-free laws/ordinances. Records were classified into pre-law and post-law based on at least one year prior to and after implementation, respectively with exclusion of implementation years. Laws with smoke-free enclosed public places were classified as strong (smoke-free enclosed public places) or weak (significant exemptions). Chi square analyses were completed to compare the births pre-and post-law. Multivariable logistic regressions were completed to relate LBW, PTB and PRIOR to ordinance timing, strength of law, and demographic explanatory variables.

Results: The sample included 75,234 records. Significant reductions in PTB and PRIOR were observed in communities post-law compared to pre-law (p <.0001). Births after implementation had reduced odds for PTB [Estimated Odds Ratio 0.87 (95% Confidence Interval 0.83-0.93)] and PRIOR [0.76 (0.73-0.79)]. Comprehensive strong laws also had reduced odds for PTB [0.94 (0.88-0.997) and PRIOR [0.94 (0.90-0.99) compared to weak laws when controlling for the other variables. No significant associations were identified for LBW.

Conclusion: Communities that adopt comprehensive smoke free laws can reduce PTB and PRIOR. These data may be used to guide tobacco policy development.

Learning Areas:
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
1. Describe three adverse health effects of prenatal secondhand smoke exposure on pregnancy outcomes. 2. List three key variables that impact preterm birth rates in communities that adopt smokefree laws. 3. Discuss the differences between comprehensive (strong) and partial (weak) smokefree laws.

Keywords: Tobacco Policy, Pregnancy Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I received my PhD in Nursing (UK,2007) and completed apost-doctoral fellowship, (NIH BIRCWH Scholar: 2007-2009). Current position: University of Kentucky College of Nursing Assistant Professor. Currently teach obstetrics, and serve as a PI for a NIH COBRE preterm birth research study. Recent honors include: 2012 BEST Teacher(UK), Excellence and Research Scholarship Award, (UK, 2011); Kentucky Nurse Researcher of the Year(2010); and Kentucky Academy of Science Outstanding Early Career in Post-secondary Education Award (2010).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.