, Volume 45, Issue 2, pp 180-191
Date: 20 Oct 2012

Pathways Linking Socioeconomic Status and Postpartum Smoking Relapse

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Low socioeconomic status (SES) exacerbates the high rate of smoking relapse in women following childbirth.


This study examined multiple models of potential mechanisms linking SES and postpartum smoking relapse among women who quit smoking due to pregnancy.


Participants were 251 women enrolled in a randomized clinical trial of a new postpartum smoking relapse prevention intervention. Four models of the prepartum mechanisms linking SES and postpartum smoking relapse were evaluated using a latent variable modeling approach.


Each of the hypothesized models were a good fit for the data. As hypothesized, SES indirectly influenced postpartum smoking relapse through increased prepartum negative affect/stress, reduced sense of agency, and increased craving for cigarettes. However, the model that included craving as the sole final pathway between SES and relapse demonstrated superior fit when compared with all other models.


Findings have implications for future interventions that aim to reduce postpartum relapse.

This manuscript was supported by grants from the National Cancer Institute (R01CA89350 to DWW; R25TCA57730 to MSB and DEK), the American Cancer Society (MRSGT-12-114-01-CPPB to MSB, MRSGT-10-104-01-CPHPS to DEK), and the CDC (K01DP001120 to LRR; K01DP000086 to JIV). This research was also supported in part by the National Institutes of Health through MD Anderson's Cancer Center Support Grant CA016672.