OBJECTIVES : Exposure to secondhand smoke (SHS) and thirdhand smoke (THS) are associated with negative impacts both on quality of life and economic burden. This study aims to assess the health-related quality of life (HRQoL) for pregnant women under three kinds of conditions which are non-exposure to smoke, exposure to SHS and THS in different regions of China.

METHODS : This study is a cross-sectional national-based study based on a questionnaire survey designed and delivered by Banmi Online maternity school from August to September, 2019. EuroQoL Group’s visual analog scale (EQ-VAS) and EuroQoL Five Dimensions Questionnaire (EQ-5D) were used. We collected the data from mainland China into seven regions.

RESULTS : This study included 12,285 pregnant women (mean age 28y), among which non-exposure to smoke are 1,887(15.4%), exposure to SHS and THS are 5,950(48.4%), and 4,448(36.2%) respectively. Exposure to tobacco shows a lower HRQoL than that of the non-exposures (p < 0.01). Pregnant women under the exposure to SHS has lower HRQoL than those under the exposure to THS (p < 0.01). Among the seven regions, the coastal developed regions including south (mean EQ-VAS value [SD]=84.96[14.30]) and east China (mean EQ-5D value [SD]=0.81[0.13]) show higher HRQoL, and the remote backward area including northwest (mean EQ-VAS value [SD]=83.96[15.30], mean EQ-5D value [SD]=0.80[0.13]) shows a lower HRQoL.

CONCLUSIONS : This study provides exposure to SHS and THS brings not only a health burden, but also an economic burden. THS also shows great effect on health problem, thus the social burdens on medical costs should not be underestimated. Government should strengthen smoking control in public areas and strengthen relevant laws.