Maternal and Child Health Journal

, Volume 15, Supplement 1, pp 96–105

Smoking Cessation and Relapse Among Pregnant African-American Smokers in Washington, DC

  • Ayman A. E. El-Mohandes
  • M. Nabil El-Khorazaty
  • Michele Kiely
  • Marie G. Gantz
Article

DOI: 10.1007/s10995-011-0825-6

Cite this article as:
El-Mohandes, A.A.E., El-Khorazaty, M.N., Kiely, M. et al. Matern Child Health J (2011) 15(Suppl 1): 96. doi:10.1007/s10995-011-0825-6

Abstract

Smoking is the single most preventable cause of perinatal morbidity. This study examines smoking behaviors during pregnancy in a high risk population of African Americans. The study also examines risk factors associated with smoking behaviors and cessation in response to a cognitive behavioral therapy (CBT) intervention. This study is a secondary analysis of data from a randomized controlled trial addressing multiple risks during pregnancy. Five hundred African-American Washington, DC residents who reported smoking in the 6 months preceding pregnancy were randomized to a CBT intervention. Psycho-social and behavioral data were collected. Self-reported smoking and salivary cotinine levels were measured prenatally and postpartum to assess changes in smoking behavior. Comparisons were made between active smokers and those abstaining at baseline and follow-up in pregnancy and postpartum. Sixty percent of participants reported quitting spontaneously during pregnancy. In regression models, smoking at baseline was associated with older age, <a high school education and illicit drug use. At follow-up closest to delivery, smoking was associated with lower education, smoking and cotinine level at baseline and depression. At postpartum, there was a relapse of 34%. Smokers postpartum were significantly more likely to smoke at baseline and use illicit drugs in pregnancy. Mothers in the CBT intervention were less likely to relapse. African-American women had a high spontaneous quit rate and no response to a CBT intervention during pregnancy. Postpartum mothers’ resolve to maintain a quit status seems to wane despite their prolonged period of cessation. CBT reduced postpartum relapse rates.

Keywords

Smoking Pregnancy African-Americans Washington, DC 

Copyright information

© Springer Science+Business Media, LLC (outside the USA)  2011

Authors and Affiliations

  • Ayman A. E. El-Mohandes
    • 1
  • M. Nabil El-Khorazaty
    • 2
  • Michele Kiely
    • 3
    • 4
  • Marie G. Gantz
    • 2
  1. 1.College of Public Health, University of Nebraska Medical CenterOmahaUSA
  2. 2.RTI International (RTI International is a trade name of Research Triangle Institute)RockvilleUSA
  3. 3.National Institutes of HealthBethesdaUSA
  4. 4.Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of HealthRockvilleUSA

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