Prevalence of male smoking is high in Indonesia especially among those living in poverty which diverts money from basic necessities to cigarettes. However, information on whether micronutrient status and women s diet are associated with the smoking status of husbands in low income households in Indonesia is generally lacking. For this purpose, we conducted a cross-sectional study among poor rural and peri-urban households.A total of 588 non-smoking women, aged 19 - 44 years, stratified by smoking (n=386) or non-smoking (n=200) husbands, was purposely selected and, data regarding socio-economic, micronutrient status, and dietary intake were collected from 2 study areas in Indonesia. Venous blood samples were obtained, and haemoglobin (Hb), ferritin, soluble transferrin receptor (sTfR), body iron, retinol binding protein (RBP), and homocysteine (Hcy) concentrations were measured. 24-hour dietary recall were used to examine the nutritional quality of women s diet. During the study, the women with their children received anthropometric assessments. The nutritional status of 482 children aged 2-6 years old were defined based on weight and height measurements: weight-for-age, height-for-age and weight-for-height.The results of this study showed that women with non-smoking husbands, in comparison to those married to smokers, had significantly lower Hcy concentration (by 0.08 µmol/L on average), after adjustment for energy intake and study area. No significant differences in Hb, ferritin, sTfR, body iron, and RBP concentrations were observed; however, expected direction of associations between micronutrient status and groups could be seen in all indicators. Women with non-smoking husbands had significantly lower prevalence of iron deficiency (ferritin <15 µg/L; 2.9 vs. 7.6%), iron deficiency anaemia (Hb <120 g/L and ferritin <15 µg/L; 1.6 vs. 5%), and deficit in tissue iron (body iron <0 mg/kg; 0.6 vs. 3.3%) than women with smoking husbands. In general there were no significant differences found in food group intakes and micronutrient intakes between the 2 groups. Inadequate micronutrient intake was the foremost problem in both areas, with reported median values of almost all micronutrients assessed being below the recommended requirements.Households with smoking husbands had similar economic constraints and a similar percentage of monthly income spent on food, to households with non-smoking husbands. Children whose fathers did not smoke were associated with higher child height-for-age Z-score (-1.99 vs. -2.25 Z-score, p=.02) than children whose fathers smoked. This resulted in a marginally lower prevalence of child stunting (49.6% vs. 62.2%, p=.07, respectively). For weight for age and weight for height no significant differences were found.Despite the found differences in micronutrient status and child growth we could not establish that households with smoking husbands spent less of their income on food or negatively influenced women s diet quality. Future studies with methodologies to better measure socio-economic status and diet and in other settings and target groups would be useful.The findings of this study support tobacco control policies in Indonesia to reduce tobacco use, circumvent further unfavourable micronutrient status of women and faltering linear growth of children living in households with smoking fathers.
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