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Smoking and Smoking Cessation During Pregnancy. An Analysis of a Hospital Based Cohort of Women in Romania

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Abstract

Perinatal smoking is associated with a wide range of negative reproductive and pregnancy outcomes. The aim of the current study was to examine the prevalence and characteristics of women who report smoking prenatally and quit during pregnancy in a large sample of Romanian women. Understanding which women are more likely to quit will contribute to public health knowledge that will help more women stop smoking prior to or during pregnancy and prevent relapse postpartum. This cross-sectional analysis was conducted based on cross-sectional data collected between May 2012 and April 2015 as part of a cohort study of pregnancy implemented in six clinical settings in central Romania (N = 2370). Approximately 28 % of the sample reported smoking in the 6 months prior to learning they were pregnant. Half of the women who reported smoking 6 months before learning of their pregnancy, also reported that they stopped smoking by the time of the interview. Overall, tobacco consumption decreased from a sample mode of 10 cigarettes/day (range: 1–30) before pregnancy, to a sample mode of 5 cigarettes/day (range: 1–25) at the time of the interview. Women who quit had a higher socioeconomic position, were more likely to live in urban areas, partnered, primigravid, nulliparous, and reported lower anxiety and more social support. The combination of a socioeconomic gradient, less anxiety, and more social support suggests that efforts should be increased to target lower income, less educated, multigravid, and multiparous women and to develop programs that heighten social support and alleviate anxiety.

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References

  1. Augood, C., Duckitt, K., & Templeton, A. A. (1998). Smoking and female infertility: A systematic review and meta-analysis. Human Reproduction (Oxford, England), 13(6), 1532–1539.

    Article  CAS  Google Scholar 

  2. Baird, D. D., & Wilcox, A. J. (1985). Cigarette smoking associated with delayed conception. JAMA, 253(20), 2979–2983.

    Article  CAS  PubMed  Google Scholar 

  3. Keegan, J., Parva, M., Finnegan, M., Gerson, A., & Belden, M. (2010). Addiction in pregnancy. Journal of Addictive Diseases, 29(2), 175–191.

    Article  PubMed  Google Scholar 

  4. Goldenberg, R. L., Culhane, J. F., Iams, J. D., & Romero, R. (2008). Epidemiology and causes of preterm birth. Lancet, 371(9606), 75–84.

    Article  PubMed  Google Scholar 

  5. Behrman, R. E., Butler, A. S. (2007). Preterm birth: Causes, consequences, and Prevention. US: National Academies Press. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK11362/.

  6. Jaddoe, V. W. V, Troe, E.-J. W. M., Hofman, A., et al. (2008). Active and passive maternal smoking during pregnancy and the risks of low birthweight and preterm birth: The Generation R Study. Paediatric and Perinatal Epidemiology, 22(2), 162–171.

    Article  PubMed  Google Scholar 

  7. McCowan, L. M. E., Dekker, G. A., Chan, E., et al. (2009). Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: Prospective cohort study. BMJ (Clinical Research Ed.), 338, b1081.

    Google Scholar 

  8. Polakowski, L. L., Akinbami, L. J., & Mendola, P. (2009). Prenatal smoking cessation and the risk of delivering preterm and small-for-gestational-age newborns. Obstetrics and Gynecology, 114(2 Pt 1), 318–325.

    Article  PubMed  Google Scholar 

  9. WHO. (2015). WHO report on the Global Tobacco Epidemic. Retrieved July 1, 2016, from http://www.euro.who.int/en/health-topics/disease-prevention/tobacco/data-and-statistics.

  10. Irimie, S. (2011). Global Adult Tobacco Survey Romania. Retrieved August 2, 2016 from http://www.who.int/tobacco/surveillance/survey/gats/gats_romania_report_2011.pdf.

  11. Zatoński, W., Przewoźniak, K., Sulkowska, U., West, R., & Wojtyła, A. (2012). Tobacco smoking in countries of the European Union. Annals of Agricultural and Environmental Medicine: AAEM, 19(2), 181–192.

    PubMed  Google Scholar 

  12. Smedberg, J., Lupattelli, A., Mårdby, A.-C., & Nordeng, H. (2014). Characteristics of women who continue smoking during pregnancy: A cross-sectional study of pregnant women and new mothers in 15 European countries. BMC Pregnancy and Childbirth, 14, 213.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Lopez, E. N., Simmons, V. N., Quinn, G. P., et al. (2008). Clinical trials and tribulations: Lessons learned from recruiting pregnant ex-smokers for relapse prevention. Nicotine & Tobacco Research, 10(1), 87–96.

    Article  Google Scholar 

  14. Center for Health Policy and Public Health. (2011). MAIA—Advancing Maternal and Child Health in Romania: An integrated assessment of the determinants of pregnancy outcomes. Retrieved August 2, 2016, from http://publichealth.ro/index.php/maia_en/.

  15. Qualtrics. (2016). Retrieved August 9, 2016 from https://www.qualtrics.com/.

  16. Wallis, A., Fernandez, R., Oprescu, F., Cherecheş, R., Zlati, A., & Dungy, C. (2012). Validation of a Romanian scale to detect antenatal depression. Open Medicine, 7(2), 216–233.

    Article  Google Scholar 

  17. Cohen, S., & Janicki-Deverts, D. (2012). Who’s Stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006, and 20091. Journal of Applied Social Psychology, 42(6), 1320–1334.

    Article  Google Scholar 

  18. Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press.

    Google Scholar 

  19. Wallis, A. B., Brînzaniuc, A., Cherecheș, R., et al. (2008). Reliability and validity of the Romanian version of a scale to measure infant feeding attitudes and knowledge. Acta Paediatrica, International Journal of Paediatrics, 97(9), 1194–1199.

    Article  Google Scholar 

  20. Wallis, A. B., Brînzaniuc, A., Oprescu, F., Cherecheş, R. M., Mureşan, M., & Dungy, C. I. (2011). A structured public health approach to increasing rates and duration of breastfeeding in Romania. Breastfeeding Medicine, 6(6), 429–432.

    Article  PubMed  PubMed Central  Google Scholar 

  21. CDC. (2016). Tobacco use and pregnancy, Reproductive health, CDC. Retrieved August 9, 2016, from http://www.cdc.gov/reproductivehealth/maternalinfanthealth/tobaccousepregnancy/.

  22. Huisman, M., Kunst, A. E., & Mackenbach, J. P. (2005). Inequalities in the prevalence of smoking in the European Union: Comparing education and income. Preventive Medicine, 40(6), 756–764.

    Article  CAS  PubMed  Google Scholar 

  23. Giskes, K., Kunst, A. E., Benach, J., et al. (2005). Trends in smoking behaviour between 1985 and 2000 in nine European countries by education. Journal of Epidemiology and Community Health, 59(5), 395–401.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Cnattingius, S. (2004). The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine & Tobacco Research, 6 Suppl 2, S125–140.

    Article  Google Scholar 

  25. Spencer, N. (2006). Explaining the social gradient in smoking in pregnancy: Early life course accumulation and cross-sectional clustering of social risk exposures in the 1958 British national cohort. Social Science & Medicine, 62(5), 1250–1259.

    Article  Google Scholar 

  26. Graham, H., Hawkins, S. S., & Law, C. (2010). Lifecourse influences on women’s smoking before, during and after pregnancy. Social Science & Medicine, 70(4), 582–587.

    Article  Google Scholar 

  27. Elsenbruch, S., Benson, S., Rücke, M., et al. (2007). Social support during pregnancy: Effects on maternal depressive symptoms, smoking and pregnancy outcome. Human Reproduction (Oxford, England), 22(3), 869–877.

    Article  CAS  Google Scholar 

  28. Dunkel Schetter, C., & Tanner, L. (2012). Anxiety, depression and stress in pregnancy: Implications for mothers, children, research, and practice. Current Opinion in Psychiatry, 25(2), 141–148.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Orton, S., Coleman, T., Lewis, S., Cooper, S., & Jones, L. L. (2016). “I Was a Full Time Proper Smoker”: A qualitative exploration of smoking in the home after childbirth among women who relapse postpartum. PLOS One, 11(6), e0157525.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Antigona, T. (2010). Guide for smoking cessation and specialized assistance for smokers (2nd ed.). Iasi: Tehnopress.

    Google Scholar 

  31. World Health Organization. (2013). WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy. Retrieved August 9, 2016, from http://www.who.int/tobacco/publications/pregnancy/guidelinestobaccosmokeexposure/en/.

  32. US Department of Health and Human Services. (2014). 2014 Surgeon General’s Report: The Health Consequences of Smoking—50 Years of Progress. Rockville. Retrieved August 9, 2016, from http://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf.

  33. Pampel, F. C., Krueger, P. M., & Denney, J. T. (2010). Socioeconomic Disparities in Health Behaviors. Annual Review of Sociology, 36, 349–370.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Eurostat. (2016). Mortality and life expectancy statistics—Statistics explained. Retrieved August 9, 2016, from http://ec.europa.eu/eurostat/statistics-explained/index.php/Mortality_and_life_expectancy_statistics.

  35. Klebanoff, M. A., Levine, R. J., Clemens, J. D., DerSimonian, R., & Wilkins, D. G. (1998). Serum cotinine concentration and self-reported smoking during pregnancy. American Journal of Epidemiology, 148(3), 259–562.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This manuscript reports on a dataset from the Advancing Maternal and Child Health in Romania: An integrated assessment of the determinants of pregnancy outcomes (MAIA) research project, financed by the Romanian Executive Agency for Higher Education, Research, Development and Innovation (UEFISCDI), through Grant Number PN-II-ID-PCE-2011-3-0942. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the funding agency. The authors would like to thank the six clinics enrolled in the study, the data collectors in the clinics and the study participants.

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Authors and Affiliations

  1. Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University Cluj-Napoca, 7 Pandurilor St, 400376, Cluj-Napoca, Cluj County, Romania

    Oana M. Blaga, Alexandra Brînzaniuc, Ioana A. Rus, Răzvan M. Cherecheș & Anne Baber Wallis

  2. Department of Epidemiology & Population Health, University of Louisville, School of Public Health & Information Sciences, 485 E Gray Street, Louisville, KY, USA

    Anne Baber Wallis

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  1. Oana M. Blaga
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  2. Alexandra Brînzaniuc
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  3. Ioana A. Rus
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  4. Răzvan M. Cherecheș
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  5. Anne Baber Wallis
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Correspondence to Răzvan M. Cherecheș.

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Blaga, O.M., Brînzaniuc, A., Rus, I.A. et al. Smoking and Smoking Cessation During Pregnancy. An Analysis of a Hospital Based Cohort of Women in Romania. J Community Health 42, 333–343 (2017). https://doi.org/10.1007/s10900-016-0259-6

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  • DOI: https://doi.org/10.1007/s10900-016-0259-6

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