Regarding the direct health effects, about 43.7% of women reported that the waterpipe Wortmannin 19545-26-7 smokers have high probability to suffer from immediate symptoms of smoking including headache, nausea, vomiting, stomach ache, and coughing, 21.5% reported that cigarette smokers have high probability to suffer from such symptoms. To assess women��s perception regarding harms of cigarette smoking to the health of the fetus, the following question was asked: In your opinion, which of the following statements apply to the effect of exposure to cigarette smoking on fetal health? Women were given the following choices: (a) cigarette smoking does not affect fetal health, (b) cigarette smoking has some negative effects on fetal health, and (c) cigarette smoking has many negative effects on fetal health.

To assess women��s perception about the effects of waterpipe smoking on fetal health, the same question was asked, but replacing ��cigarette�� with ��waterpipe.�� The results show that comparable percentages of women believed that either waterpipe (80.8%) or cigarette (76.4%) smoking are associated with negative health effects on the fetus. Discussion In this study, we examined the prevalence and the pattern of cigarettes and waterpipe smoking among pregnant women in Jordan. The data indicate that approximately 15% of the pregnant women in Jordan smoke tobacco during pregnancy. Higher prevalence rates were reported in some developed and developing countries including France (36%; Lelong, Blondel, & Kaminski, 2011), United Kingdom (27%; Fleming & Blair, 2007), Lebanon (25.

7%; Bachir & Chaaya, 2008), and Serbia (37.2%; Krstev, Marinkovic, Simic, Kocev, & Bondy, 2011). In other countries, different estimates were reported: United States (10.2%), Japan (8.9%) (Suzuki et al., 2010), Australia (17.4%; Thrift, Nancarrow, & Bauman, 2011), Tunisia (4%�C18.8%; Fakhfakh et al., 2011), Romania (15%; Meghea, Rus, Rus, Summers Holtrop, & Roman, 2010), and Poland (8%; Perz, Gaca, Mniszak, & Wesol, 2006). In this study, about 83% of the sample reported that they were exposed to tobacco smoke from both cigarette and waterpipe (passive smoking). Reports from several countries indicated that rates of secondhand smoke exposure during pregnancy ranged between 17% and 94% (Bloch et al., 2008; Franchini et al., 2008; Kelly et al., 2011; Torres et al., 2011; Yang, Tong, Mao, & Hu, 2010).

In previous studies from Jordan, exposure to secondhand cigarette smoke among Jordanian women was about 70% in a sample of patients admitted to a local hospital, using a survey that was developed by the researchers (Zmeili, 1992) while another study indicated that 60% of mothers were exposed to secondhand smoke from other GSK-3 family members at home using both survey instrument and biomarkers of exposure to cigarettes (nicotine and cotinine plasma levels [n = 220, Badran, Salhab, & Al-Jaghbir, 2009]).