Abstract
Backgorund: smoking is reducing slowly among women living in low- and middle-income countries (LMIC). During pregnancy, smoking may have negative effects on foetal and newborn health. Aim: To evaluate inequalities in smoking prevalence during pregnancy in LMIC. Methods: 53 Demographic and Health Surveys (DHS) carried out between 2001 and 2013 were included in this study. Only the most recent survey available for each country was considered. Current smoking was defined as having smoked cigarettes, pipes or other specific country tobacco product. Inequalities were assessed using quintiles of wealth index, slope index of inequality (SII) and concentration index (CIX). Results: the mean prevalence of current smoking was 1.6%, ranged from 0 in Guatemala (1998) up to 15% in Turkey (2003). In general, prevalence was higher among the poorest (2.1%) than in the richest (1.5%). Pro-poor inequalities patterns were observed in 21 countries and 15 presented pro-rich patterns. Only six countries have smoking during pregnancy prevalence higher than 4%. Among those countries, Nepal (2011) had the highest pro-poor inequalities (SII = -0.26; CIX = -0.64) while Namibia (2006) had the highest pro-rich inequalities (SII = 0.12, CIX = 0.33). Regarding UN regions, West & Central Africa (SII=0.0002) and Eastern & Southern Africa (SII = 0.005) showed lower absolute inequalities. In East Asia & Pacific (Q1 = 4.5% and Q5 = 0.8%, SII = -0.04) and in South Asia (Q1 = 7.3% and Q5 = 0.8%, SII = -0.09) regions presented the highest absolute inequalities. Conclusions: smoking during pregnancy has a relative low prevalence in the countries studied. Inequalities vary at country and regional levels.