1 Centre for Research on Inner City Health, The Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Eur J Public Health. 2014 Feb;24(1):122-7. doi: 10.1093/eurpub/ckt048. Epub 2013 May 30.
Smoking during pregnancy has been declining in the past decades in high-income countries, including Sweden. Paradoxically, increasing trends associated with duration of residence have been reported among immigrants. We aimed to clarify how these two contrasting trends have shaped smoking patterns among immigrants.
We conducted a population-based study of 1 598 433 pregnancies in Sweden in the period 1992-2008. We used multinomial logistic regression to estimate the odds of mild and heavy smoking relative to no smoking associated with year of delivery, years since migration, maternal region of birth and their interaction, after controlling for potential confounders.
The prevalence of smoking decreased for the Swedish-born and for immigrants during the study period. Among immigrants, duration of residence was independently associated with increases in smoking and varied according to maternal region of birth (P-value for interaction <0.001). The odds ratio associated with a 10-year increase in duration of residence was weakest for mild smoking among former Yugoslav women (adjusted odds ratio; 95% confidence interval: 1.10; 1.04-1.17) and those from other Nordic countries (1.22; 1.17-1.26) and strongest for heavy smoking among East African (4.46; 3.23-6.16) and sub-Saharan African (3.56; 2.68-4.72) women. The association between duration of residence and smoking was attenuated after stratifying by cohorts of arrival among European but not among non-European immigrants.
Declines in smoking during pregnancy among immigrants from various regions of the world were differentially affected by opposite increasing trends throughout their residence in Sweden.
在过去几十年中，包括瑞典在内的高收入国家的孕妇吸烟率呈下降趋势。但具有讽刺意味的是，报告显示移民的居住时间与吸烟率呈上升趋势有关。我们旨在阐明这两种相反的趋势如何影响移民的吸烟模式。
我们对瑞典 1992-2008 年间的 1598433 例妊娠进行了一项基于人群的研究。我们使用多项逻辑回归来估计与不吸烟相比，与分娩年份、移民年限、母亲出生地以及它们之间的交互作用相关的轻度和重度吸烟的几率，在控制了潜在混杂因素后。
在研究期间，瑞典出生的人和移民的吸烟率都有所下降。在移民中，居住时间与吸烟的增加独立相关，且因母亲出生地而异（交互作用 P 值<0.001）。与居住时间增加 10 年相关的比值比在以前南斯拉夫妇女和其他北欧国家妇女中轻度吸烟的关联最弱（调整比值比；95%置信区间：1.10；1.04-1.17），而在东非和撒哈拉以南非洲妇女中重度吸烟的关联最强（4.46；3.23-6.16）。在按欧洲和非欧洲移民的到达队列分层后，居住时间与吸烟之间的关联减弱。
来自世界各地不同地区的移民在怀孕期间吸烟率的下降受到其在瑞典居住期间相反的上升趋势的不同影响。
