Smoking study aims to improve health outcomes for First Nations children
When Vanessa Withington’s waters broke as she waited for breakfast in a fast-food drive-through, her mind raced through everything she needed to do before giving birth.
She had some extra tasks ahead of her as she went into labour because she was taking part in a “trailblazing” study investigating the impact of cigarette smoke on Indigenous infants.
As her partner Matt Hearps rushed her to Hervey Bay hospital, in Queensland’s Wide Bay, she awkwardly collected as much of her amniotic fluid as possible into a small sterile container, before having a saliva test at the hospital.
The samples were needed for a study involving Ms Withington and 82 other expectant mothers to understand one of the most significant gaps in health outcomes for First Nations newborns: how they are affected by cigarette smoke.
Indigenous kids exposed to nicotine during pregnancy are more likely to have adverse outcomes. (ABC Northern Tasmania: Fred Hooper)
“Trying to collect your fluids while you’re driving is very difficult,” Ms Withington said.
“It was hard to remember, because of all the pain; it was very difficult, but we made it — we did it.“
Effects of smoking
Ms Withington and Mr Hearps’ child Thomas was born without complications and was “absolutely perfect”, she said.
Ms Withington herself was born to English parents and Mr Hearps is a Kamilaroi man, giving Thomas First Nations heritage.
According to research, Indigenous babies are more likely to have adverse outcomes from nicotine exposure compared to non-Indigenous babies exposed to smoking.
Vanessa Withington, Matt Hearps and Thomas took part in the study. (ABC Wide Bay: James Taylor)
Mr Hearps smoked cigarettes at home throughout the pregnancy, and Ms Withington did herself for about the first three months.
Tobacco smoke exposure during pregnancy increases the likelihood of Indigenous babies being born preterm or underweight, moreso than non-Indigenous kids.
They also face almost twice the stillbirth risk of non-Indigenous babies.
Understanding the genetic factors underlying this disparity is one of the primary goals of the project led by Angela Ratsch, director of research at Wide Bay Hospital and Health Service.
“When a Caucasian woman is smoking, the birth outcomes of their babies are less adverse than when an Indigenous woman is smoking,” Dr Ratsch said.
“And we don’t understand why, because it doesn’t make sense.“
Angela Ratsch says why health outcomes differ is unknown. (ABC Wide Bay: James Taylor)
Using a $300,000 grant from the Queensland government, in 2021 Dr Ratsch formed a collaboration with the local Aboriginal healthcare service, Galangoor Duwalami Primary Healthcare Service, and traditional owners from the Butchulla community.
Eighty-three families expecting an Indigenous baby were recruited for the project.
From May 2022 to July 2024 they gave regular urine and saliva samples and answered questions about their recent exposure to nicotine.
Of the 83 women, 70 said they were exposed to nicotine during their pregnancy, through cigarettes, vapes and cannabis smoked by themselves or someone else living in their home.
In addition to the amniotic fluid, samples of the placenta were taken at birth to enable an evaluation of the impact of nicotine on the developing foetus.
Impacts on DNA investigated
Georgia Kafer is a foetal and reproductive health researcher at the University of the Sunshine Coast, specialising in placental biology.
Not herself directly involved in the study, Dr Kafer said it was “trailblazing” for its co-designed approach and the way it considered the impact of a variety of means of nicotine ingestion on the developing foetus.
“It’s the first of its kind in the world … there is nothing else like this,”
she said.
“Some of the work has been presented in conferences and I know that it’s always been really well received by the scientific community … [Dr Ratsch] is doing it the right way.”
An analysis of the samples obtained through the study is now underway, with results expected by the end of 2025.
Dr Ratsch says the project will develop culturally sensitive quit smoking messaging. (ABC Wide Bay: James Taylor)
Dr Ratsch hopes the analysis will yield insights into the ways in which the DNA of the mother and child are impacted by nicotine, enabling the development of diagnostic tests to help clinicians administer interventions early in pregnancy.
The development of culturally sensitive messaging and other support services is another aim of the project.
Stigma around smoking
With guidance from Butchulla elder Uncle Glen Miller, Dr Ratsch was inspired to consider both mothers’ and fathers’ nicotine use in the study, pointing out intergenerational effects of smoking in Indigenous communities.
Butchulla elder Uncle Glen Miller persuaded Dr Ratsch to include an evaluation of passive smoking in the study. (ABC Wide Bay: James Taylor)
“This is probably the first time that those young people have ever been asked to participate in anything that shows concern for their health,” he said.
Ms Withington quit smoking through her participation in the project and hopes the study will encourage more pregnant women to reach out for help.
“I think people need to not be afraid to tell medical professionals, but I do think there’s a stigma around it,”
she said.
“I hope it makes a big difference in [encouraging women] to open up about it and say, ‘I do need help, I want to quit.'”
link
