South Asia has one of the highest numbers of male smokers anywhere in the world. As a result, over a third of pregnant women in South Asia are exposed to second-hand smoke in their homes. This has serious health consequences for both mothers (such as increased heart- and lung-related illnesses) as well as the newborn (higher chances of stillbirth, being born prematurely and lung-related illnesses). On the other hand, the antenatal period provides a window of opportunity to change health-related behaviours in the entire family. Interventions that are effective in reducing the exposure of pregnant women to second-hand smoke have been tried successfully in richer countries but have not been adapted for large-scale implementation in lower and middle-income countries.
Our proposed project addresses this gap in two such countries - urban Bangalore, India and peri-urban Comilla, Bangladesh. The sites are situated in a region with the greatest burden of disease from the effects of second-hand smoke globally. The project has two broad aims: the first is to adapt existing knowledge about what is known to work, into an acceptable and feasible intervention that can be delivered to the woman and her family members. This may include informing the woman and her family about the levels of second-hand smoke in her body measured by a simple test on her saliva; educating the whole family about the harmful effects of second-hand smoke on the mother and baby; and using 'communication-techniques' from the field of psychology and behavioural sciences to encourage husband and other family members to change the habit of smoking in the pregnant mother's presence. The second aim is to apply scientific methods to test the effectiveness of this intervention in reducing the exposure of pregnant women and newborn to second-hand smoke in both sites, and to determine the costs versus benefits of implementing such an intervention. The findings from the study will be shared with key academic, policy and community stakeholders throughout the duration of the project.