Postpartum Smoking Relapse Research Articles

Smoking Among Low‐Income, Pregnant Women: Prevalence Rates, Cessation Interventions, and Clinical Implications

Smoking has a significant effect on the major causes of death and disability among women, including coronary heart disease, stroke, cancer, and osteoporosis. When pregnant women smoke, it adversely affects not only them but also the health, development, and functioning of their unborn and young children. Of the general population of pregnant women, between 20 and 45 percent smoke. Furthermore, among low-income and less educated pregnant women, the increase in prevalence of postpartum smoking relapse rates, continued smoking, and initiation of smoking underlies the need for developing effective interventions for prevention and cessation. Although self-help, stop-smoking materials demonstrated success in several trials, interventions used in conjunction with these materials were brief with little follow-up, and did not address the need for continued intervention to help maintain abstinence or cessation after birth. This article reviews the smoking cessation trials that have assessed the effects of various interventions on cessation rates among low-income pregnant women, and describes future research needs for clinic-based smoking interventions for those women and the clinical implications for health professionals.

The Impact of Pregnancy on Women’s Prenatal and Postpartum Smoking Behavior

We report patterns of prenatal smoking cessation and postpartum relapse for a large urban population of pregnant women. We examined associations between sociodemographic factors and prepregnancy, pregnancy, and early postpartum smoking behavior. Forty-one percent of women smoking before pregnancy quit smoking during pregnancy. Sociodemographic factors important in predicting smoking cessation during pregnancy, as determined through logistic regression analyses, differed significantly for white and black women. Among white women, education, age, and parity were important predictors of cessation, whereas among black women, only intention to breastfeed was a significant predictor of smoking cessation during pregnancy. Early postpartum smoking relapse rates differed by ethnicity. Twenty-eight percent of white women and 46% of black women who had quit during pregnancy relapsed within 6-12 weeks postpartum. Using logistic regression, we found formula feeding to be the most important predictor of early postpartum smoking relapse for both white and black women.

Postpartum relapse to smoking: a prospective study.

A substantial proportion of women who quit smoking during pregnancy will relapse in postpartum. In order to better understand the psychosocial factors which precipitate relapse to smoking we conducted a prospective study of postpartum smoking relapse among a cohort (N = 106) of women who quit smoking during pregnancy. Participants were surveyed by telephone after the 28th week of pregnancy, and at 6 weeks and 6 months postpartum. Point prevalence estimates of smoking relapse indicated that at 6 weeks and 6 months follow-up, 24% (n = 26) and 40% (n = 42), respectively, of the women had returned to regular smoking. Spouse's smoking status, social support, decreases in self-efficacy, and the types of coping strategies used to resist smoking in pregnancy and postpartum predicted relapse to smoking in postpartum. Longitudinal data indicated that relapse occurred relatively gradually suggesting that early postpartum is not too late to encourage new mothers to remain abstinent.

Postpartum smoking relapse

While it has been established that many women quit smoking during pregnancy, little is known about postpartum maintenance of smoking cessation and relapse. A sample of 567 women were surveyed at about 6 months postpartum in order to (a) describe the patterns of smoking relapse; (b) assess the perceived importance of smoking cessation in pregnancy and postpartum; and (c) identify potentially high risk situations for smoking relapse. Results indicate that about half (56%) of the women who quit smoking during pregnancy relapse to smoking by 30 days postpartum. Most of these relapses occur in the company of other smokers. Socializing and/or living with a smoker had a powerful negative impact on ability to maintain abstinence in postpartum. Smoking cessation programs for pregnant women should emphasize the importance of continued abstinence in postpartum.