Assessment of foetal exposure to cigarette smoke after recent implementations of smoke-free policy in Italy

Aim: We investigated foetal exposure to cigarette smoke following maternal active and passive smoking at the end of the pregnancy in a cohort of mother-infant dyads after recent implementation of the Italian smoke-free legislation and information campaigns against smoking. Methods: Study subjects were 979 mothers and their newborns attended at one of the major Florence hospitals between the end of 2004 and during 2005, when smoking banning legislation in all the enclosed places of employment was completely enforced. A structured questionnaire was completed by mothers and cord serum cotinine was used as a biomarker of foetal exposure to maternal smoke at the end of the pregnancy. Results: Women (53.9%) declared to be non-smokers not exposed to environmental tobacco smoke (ETS), 33.5% to be exposed non-smokers, while 12.6% reported daily smoking during pregnancy. Based on the levels of cord serum cotinine, 78.9% newborns were not exposed to ETS, 13.5% were exposed to ETS and 7.7% were exposed to active maternal smoke. Conclusions: Smoke-free policies can be an effective strategy for reducing both first-hand and second-hand exposure to cigarette smoke in pregnant women and their newborns. Due to the implementation of smoke-free legislation and information campaigns against smoking, a significant trend towards less active smoking during pregnancy was observed in our study cohort, as well as a minimal exposure to ETS in non-smoking pregnant women and their newborns.