Burden and Correlates of Tobacco Use During Pregnancy: Insights From an Urban Resettlement Colony of Delhi

Introduction Antenatal tobacco exposure poses significant risks to maternal and fetal health, with implications that extend throughout the life course. Despite these risks, the use of tobacco among pregnant women persists in India, largely driven by sociocultural beliefs, prevailing myths, and inadequate awareness regarding its detrimental effects. Methods A community-based cross-sectional study was undertaken among 200 pregnant women residing in an urban resettlement colony of Delhi to estimate the burden, usage patterns, and determinants of tobacco consumption and second-hand smoke (SHS) exposure. Systematic random sampling was employed for participant selection. Data were collected through structured, interviewer-administered questionnaires and analyzed using SPSS version 25 (IBM Corp., Armonk, NY, USA). A <i>p</i>-value ≤ 0.05 was considered statistically significant. Results The prevalence of current smokeless tobacco (SLT) use was 14 (7%), comprising 10 (5%) less-than-daily and four (2%) daily users. Ghutka was the predominant product used by 12 (85.8%), followed by a combination of Ghutka and Paan. Among daily users, eight (57.1%) reported consumption around four to six times/day, while the rest used it for more than six times/day. Significant associations were observed between current SLT use and sociodemographic variables such as age, educational attainment, employment status, and socioeconomic class. SHS exposure within the household environment was reported by 79 (39.5%) of participants. Public transport emerged as the most frequently observed site of smoking (57.5%), with the lowest frequency reported in educational institutions (0.5%). Awareness regarding the adverse effects of SLT use during pregnancy was limited to 29 (14.5%), and was significantly correlated with age, education level, and socioeconomic status. Notably, none of the SLT users had attempted cessation or received any formal advice or support to quit in the preceding 12 months. Awareness of national cessation services, including the tobacco quitline, was negligible. Conclusion The findings reveal a substantial burden of antenatal tobacco exposure, both direct and passive, within vulnerable urban populations, compounded by limited risk perception and absence of cessation support. The integration of tobacco control strategies within routine antenatal care services, coupled with targeted awareness campaigns and behavioral interventions, is imperative to mitigate these preventable risks.