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Epidemiological data indicate that-globally 250 million women and 1 billion men smoke every day. Unfortunately the prevalence of smoking among women is continuing to increase and it is expected to rise from 12% noted in the first decade of this century to 20% in 2025. Women are as vulnerable as men to the dangers of tobacco and additionally the tobacco smoking can cause also female-specific cancer, respiratory diseases and can increase the risk poor pregnancy outcome. There are various recommendations from the World Health Organization which include the need for governments to introduce tobacco control strategies which are sensitive to gender. Efforts should be taken not only to sustain the downward trend in male smoking but also on reversing the levels of smoking in girls and women. The aim of this paper is to analyze the existing recommendations developed by WHO with more specific focus on promotion of gender specific action which can lead to decreasing in the prevalence of female smoking.

The aim of the study was to analyze the association between prenatal environmental tobacco smoke exposure (ETS) and child anthropometric parameters at birth such birth weight, length, head and chest circumference. The study population consisted of 107 pregnant women from Lodz district as the part of Polish Mother and Child Cohort study. The child prenatal ETS exposure was assessed based on questionnaire with mothers and cotinine level in saliva collected three times in pregnancy. The level of cotinine in biological samples was analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS ESI+). About 35% of the children were prenatally exposed to ETS. The birth weight of the children prenatally exposed to ETS was 335 g lower than the birth weight of non-exposed newborns p0.001 after adjustment for: maternal educational level, marital status, prepregnancy weight, child gender, and gestational age. The same refers to child length and chest circumference (coef. -1.1 cm; p = 0.03 and coef. -1.3 cm; p = 0.002 respectively). Taking into account the negative effect of prenatal exposure to ETS, more efforts need to be taken to eliminate child ETS exposure.

The aim of the study was to evaluate smoking prevalence and exposure to environmental tobacco smoke among school administrators. The study population consisted of 320 administrative workers in schools from Lodz district. Among the study participants self-administrative questionnaire was conducted. The questionnaire focused on socio-demographic characteristics, detail information about active smoking and environmental tobacco smoke exposure. Current tobacco smoking was indicated by 19% of women and 28% of men (p = 0.06). Only 35% of the study subjects declared willingness to give up the habit. Significantly less men than women felt that they should quit smoking (36% vs. 11.4%, p0.05). Only small part of the study population expected the help in quitting smoking from specialists, physicians or school. It is crucial to increase awareness among the school administrators about negative effects of smoking and to motivate them to give up the habit. About 7% of study subjects (5% of women and 11% of men, p0.05) declared that smoking is allowed in school building and 13% of them indicated that there are no regulations on it or did not know such regulations.

The aim of the study was to analyze the opinion of administrative personnel in school on smoke-free regulations. The study population consisted of 320 subjects. Among the study population questionnaire was conducted including socio-demographic characteristic, smoking and SHS profile. Detail information was collected about opinion on smoke-free public places such as offices, other workplaces, health and educational buildings, restaurants and bars. About 22% of study population declared current tobacco smoking. More current everyday smoking was observed among men comparing to women (17.8% vs. 9.1%; p0.05). The study indicated that high percentage support total ban of smoking in public offices (84%), health care buildings (89%), and educational buildings (86%). 60% of the study subject were in favor of smoke-fee restaurants and 38% sypport smoke-free burs, pubs and clubs. The strong approval for ban on tobacco product advertising was indicated by 41% of respondents and 38% of them expect pictorial warnings on tobacco packs.

The aim of the study was to evaluate the prenatal and postnatal child exposure to environmental tobacco smoke. The study population consisted of 83 women from Lodz, Poland among which detail questionnaire was conducted three times during pregnancy period. From all women included into the study the saliva sample was collected to verify smoking status in pregnancy. One year after delivery the second questionnaire was performed and urine sample from all children was collected. The cotinine level in saliva and urine was analyzed using Liquid Chromatography with Tandem Mass Spectrometry (LC-MS/MS ESI+). About 22% of the children were expose to ETS during prenatal and 46% in postnatal period. Cotinine level in children's urine statistically differentiated children from smoking mothers (Geometric Mean (GM) 11.4 ng/ml; 95% CI 7.1-18.3) and exposed homes (GM 7.3 ng/ml; 95% CI 3.6-15.0) compared with non-exposed homes (GM 1.3 ng/ml; 95% CI 0.9-1.7) (p0.001). Children should be more protected from ETS exposure in prenatal and postnatal period.

The aim of the study was to evaluate the nurses' knowledge about health effects of active and passive smoking and their attitude towards providing smoking cessation activities. The study population consisted of 299 nurses. About 57% of the women thought that some kind of cigarettes can be less dangerous than other. Almost all of the nurses indicated that tobacco smoking may lead to addiction. Unfortunately only 67% of study population thought that sidestream smoke contains substances dangerous for health. All nurses indicated that tobacco smoking causes lung cancer and 77% of them that it can cause cardio-vascular diseases and only 26% that it increases the risk of bladder cancer. Almost all women indicated that environmental tobacco smoke exposure is dangerous for pregnant women and the faetus. The nurses were educated about health effects of active and passive smoking but they have limited knowledge about the methods used in antismoking counseling.

The aim of the study was to analyze the nurse attitudes towards smoke-free regulations in public places. The study population consisted of 299 nurses. Among the study population questionnaire was conducted including socio-demographic characteristic, smoking and ETS profile, knowledge about health effects of smoking and abilities for conduction of antismoking counseling. Detail information was collected about nurse opinion on smoke-free public places such as offices, other workplaces, health and educational buildings, restaurants and bars. About 18% of study participants declared current tobacco smoking and 25% were former smokers. Almost all participating in the study women (85%-98%) are in favor of smoking ban in offices, health and educational buildings. 75% supported smoking ban in workplaces but 15% of them were somewhat opposed. Most of the nurses were in favor of smoke-free restaurants (64%) but they were less likely to support smoke-free bars, pubs and clubs (45%). Unfortunately 63% of interview women do not accept smoking ban in private cars. The percentage of women who support total ban of smoking in the presence of pregnant women was 93% and in the presence of children 79%. It is important to conduct educational and informational activities to increase public awareness on health consequences of active and passive smoking and the ways of elimination of such exposures.

The aim of the study was to evaluate the nurses' exposure to active and passive smoking. The study population consisted of 299 nurses. Among the study population detailed questionnaire was conducted incusing sociodemographic characteristic, smoking profile and environmental tobacco smoke exposure. About 18% of nurses indicated current tobacco smoking and 25% smoking in the past. Only 13% of the study population declared complete ban of tobacco smoking in their homes and 20% indicated exposure to tobacco smoke in the workplaces. The women were most frequently exposed to inhaling tobacco smoke in bars and pubs (97%), restaurants (65%) and in private cars (64%).

The aim of the study was to evaluate the effectiveness of antismoking counseling for postpartum women. The study was conducted between 2004-2006 in Lodz district. The study population consisted of 199 women and among them 100 were included into the intervention group and 99 to control one. Antismoking intervention and control activities were conducted among the women who quit smoking during pregnancy and maintained smoking abstinence after delivery. There were no statistically significant differences regarding the socio-demographic characteristic between intervention and control group. The women who received antismoking advice relapsed into the smoking less frequently than the women from the control group (26% vs. 56%; OR = 0.25; 95% CI 0.15-0.51). The antismoking counseling for postpartum women is the effective tool to help them to maintain smoking abstinence.

Smoking plays an important role in no communicable diseases including cardiovascular diseases etiology. In recent years more attention has been paid to the role of physicians in smoking prevention and treatment. The aim of this study was to analyze the presence of antismoking counselling given by physicians among the patients with the risk factors for cardiovascular diseases. The study was performed in the randomly selected group of 1267 men and women aged 18-65 years from Lodz and Lublin district. Each surveyed person had medical examination, blood pressure measured, anthropometry, biochemical tests included a full lipidogram and glucose concentration. Moreover detailed questionnaire surveys were conducted. Logistic regression models were applied to assess role of factors influencing undertaken of antismoking counseling among the patients with risk factors of cardiovascular diseases. The study revealed that smoking addiction affected 44% males and 23 % females. Abdominal obesity frequency in males was 24% and in females 35%. Hypertension was diagnosed in 30% of males and 21% of females, hyperlipidemia was diagnosed in 29% men and 19% women. High glucose concentration was identified in 7% of men and 5% of women. Only half of the smoking population received anti-smoking counselling given by physician. More frequently antismoking advice was given to the patients with abdominal obesity, (68%), and hypertension (67%). Only 36% of people with high glucose concentration received antismoking advice. This study results revealed, that anti smoking treatment among adults should be consider as an important part of preventing strategies. More effort should be given to increase awareness of physicians relating to the smoking habit of their patients.

The aim of the study was to analyze the active smoking by pregnant women in different weeks of pregnancy. The study population consisted of 136 women before 22 weeks of pregnancy. The women were interviewed three times during pregnancy. From all women included into the study the saliva sample was collected three times to verified smoking status in pregnancy. Cotinine level in saliva was analyzes using Liquid Chromatography with Tandem Mass Spectrometry. Based on interview about 25-30% of pregnant women smoked cigarettes during pregnancy. This percentage was higher when the smoking status was verified using cotinine level in saliva (33-41%). In the group of pregnant women who smoked cigarettes there was no decreasing trend in cotinine level during pregnancy whereas in nonsmokers the decreasing trend was observed. Unmarried women, those with lover educational level, and unemployed had the highest risk of smoking during pregnancy.

Most of women who quit smoking during pregnancy return to smoking within 12 months after delivery. Since smoking cessation is more likely during pregnancy than at other times, interventions to maintain quitting postpartum may give the best opportunity for a long-time abstinence. It is still not clear what kind of advice or counseling should be given to help prevent the post-delivery relapse. To find an answer to that question, we need to know which factors predispose the women for and which protect from restarting smoking after delivery. The profile of women who relapse to smoking can be described as living with smokers. Breastfeeding and positive experience related to the quitting of smoking protect the women from returning to smoking after delivery. Those factors should be taken into account while creating antismoking intervention.

Among available methods to estimate the exposure to tobacco smoke, cotinine, a major metabolite of nicotine is considered the most accurate marker. The aim of this study was to evaluate environmental tobacco smoke exposure in pregnancy and postpartum period. The cohort study was conducted in 2004 and 2006 in public maternity units in Lodz, Poland. The study population consisted of women between 32-36 weeks of pregnancy who have quit smoking within 2 months before pregnancy or no later than three months prior to participation in the study. Women were interviewed twice: during pregnancy and three months after delivery. Self-reported non-smoking status was verified using saliva cotinine level. Cotinine level in saliva sample was analyzed using Liquid Chromatography with Tandem Mass Spectrometry. We included into the analysis 62 women who, based on self-reported smoking status and saliva cotinine level were classified as non-smokers. There were no statistically significant differences in mean saliva cotinine level measured in pregnancy and postpartum period. Pregnant women who smoked more cigarettes per day before quitting smoking had significantly higher cotinine level comparing to women who smokedor = 10 cigarettes per day (p = 0.03). Saliva cotinine level was significantly higher among women exposed to environmental tobacco smoke at home compared to non-exposed (p = 0.02).

The aim of the study was to characterize the smoking habit among pregnant women and evaluate the effectiveness of antismoking intervention based on the results of the test "Why am I smoker?". A randomized trial was conducted between December 1, 2000, and December 31, 2001, in public maternity centers in Lódź, Poland. We included into the study all women below 36 weeks of pregnancy who smoke at least one cigarette per day (intervention group - 149 smokers, control group- 144 smokers). The intervention consisted of five visits of the midwife to the home of the smoking pregnant woman. The intervention was based on the results of the test "Why am I smoker?". The results of the test "Why am I smoker?" give the good characteristics of the smoking habit among pregnant women. The intervention based on the results of this test seems to be an effective tool to help them quit smoking.