Maternal and Child Health Journal

, Volume 17, Issue 6, pp 1151–1157 | Cite as

Smoking Status and Factors Associated with Smoking of First-Time Mothers During Pregnancy and Postpartum: Findings from the Healthy Beginnings Trial

  • Huilan Xu
  • Li Ming Wen
  • Chris Rissel
  • Louise A. Baur
Article

Abstract

This study aimed to investigate smoking status and factors associated with smoking among first-time mothers and their partners during pregnancy and postpartum. A prospective cohort study with 201 first-time mothers was conducted using data from the Healthy Beginnings Trial, undertaken in one of the most socially and economically disadvantaged areas of south-western Sydney, Australia in 2007–2010. Smoking status of the mothers and their partner and smoke-free home status were assessed at 30–36 weeks of pregnancy, and also at 6, 12 and 24 months postpartum. Multivariable two-level logistic random-intercept models were conducted. Smoking rates of the first-time mothers were 17.6 % during pregnancy and 22.5 % postpartum. The likelihood of being a current smoker among the mothers significantly increased after giving birth, with an adjusted odds ratio of 3.96 (95 % CI 1.3–12.1) at 6 months, 6.19 (95 % CI 1.84–30.9) at 12 months, and 6.58 (95 % CI 1.86–23.23) at 24 months postpartum. Mothers’ smoking status was significantly inversely associated with educational level and positively associated with their partner’s smoking status. In addition, mothers who breastfed their child were significantly less likely to be a smoker, with an adjusted odds ratio of 0.10 (95 % CI 0.02–0.68). Although pregnancy may act as a motivator to quit smoking, it is of concern that maternal smoking rate increased after giving birth. Smoking cessation programs should not only focus on smoking in pregnancy, but also address other risk factors, particularly in postpartum women and their partners.

Keywords

Smoking status First-time mothers Pregnancy and postpartum 

Notes

Acknowledgments

This is part of the Healthy Beginnings Trial funded by the Australian National Health and Medical Research Council (ID number: 393112). We wish to thank all the families for their participation in this study. We also thank members of the project team based at Health Promotion Service, South Western Sydney & Sydney Local Health Districts.

Conflict of interest

The authors declare that they have no competing interests in this study.

References

  1. 1.
    Edwards, N., & Sims-Jones, N. (1998). Smoking and smoking relapse during pregnancy and postpartum: Results of a qualitative study. Birth, 25(2), 94–100.PubMedCrossRefGoogle Scholar
  2. 2.
    Johnson, J. L., Ratner, P. A., Bottorff, J. L., Hall, W., & Dahinten, S. (2000). Preventing smoking relapse in postpartum women. Nursing Research, 49(1), 44–52.PubMedCrossRefGoogle Scholar
  3. 3.
    Levitt, C., Shaw, E., Wong, S., & Kaczorowski, J. (2007). The McMaster University Postpartum Research Group. Systematic review of the literature on postpartum care: effectiveness of interventions for smoking relapse prevention, cessation, and reduction in postpartum women. Birth, 34(4), 341–347.PubMedCrossRefGoogle Scholar
  4. 4.
    Colman, G. J., & Joyce, T. (2003). Trends in smoking before, during, and after pregnancy in ten states. American Journal of Preventive Medicine, 24(1), 29–35.PubMedCrossRefGoogle Scholar
  5. 5.
    Mullen, P. D., Richardson, M. A., Quinn, V. P., & Ershoff, D. H. (1997). Postpartum return to smoking: who is at risk and when. American Journal of Health Promotion, 11(5), 323–330.PubMedCrossRefGoogle Scholar
  6. 6.
    Polanska, K., Hanke, W., Sobala, W., Lowe, J. B., & Jaakkola, J. J. K. (2011). Predictors of smoking relapse after delivery: Prospective study in central Poland. Maternal and Child Health Journal, 15, 579–586.PubMedCrossRefGoogle Scholar
  7. 7.
    Fang, W. L., Goldstein, A. O., Butzen, A. Y., Hartsock, A., Hartmann, K. E., Helton, M., et al. (2004). Smoking cessation in pregnancy: A review of postpartum relapse prevention strategies. JABFP, 17(4), 264–275.PubMedCrossRefGoogle Scholar
  8. 8.
    Letourneau, A. R., Sonja, B., Mazure, C. M., O’Malley, S. S., James, D., & Colson, E. R. (2007). Timing and predictors of postpartum return to smoking in a group of inner-city women: An exploratory pilot study. Birth, 34(3), 245–252.PubMedCrossRefGoogle Scholar
  9. 9.
    Kahn, R. S., Certain, L., & Whitaker, R. C. (2002). A reexamination of smoking before, during, and after pregnancy. American Journal of Health Promotion, 92(11), 1801–1808.Google Scholar
  10. 10.
    Ma, Y., Goins, K. V., Pbert, L., & Ockene, J. K. (2005). Predictors of smoking cessation in pregnancy and maintenance postpartum in low-income women. Maternal and Child Health Journal, 9, 393–402.PubMedCrossRefGoogle Scholar
  11. 11.
    DiSantis, K. I., Collins, B. N., & McCoy, A. C. (2010). Associations among breastfeeding, smoking relapse, and prenatal factors in a brief postpartum smoking intervention. Acta Obstetricia et Gynecologica Scandinavica, 89(4), 582–586.PubMedCrossRefGoogle Scholar
  12. 12.
    Giglia, R. C., Binns, C. W., & Alfonso, H. (2006). Maternal cigarette smoking and breastfeeding duration. Acta Paediatrica, 95(11), 1370–1374.PubMedCrossRefGoogle Scholar
  13. 13.
    Giglia, R. C., Binns, C. W., & Alfonso, H. S. (2006). Which women stop smoking during pregnancy and the effect on breastfeeding duration. BMC Public Health, 6, 195.PubMedCrossRefGoogle Scholar
  14. 14.
    Higgins, T. M., Higgins, S. T., Heil, S. H., Badger, G. J., Skelly, J. M., Bernstein, I. M., et al. (2010). Effects of cigarette smoking cessation on breastfeeding duration. Nicotine & Tobacco Research, 12(5), 483–488.CrossRefGoogle Scholar
  15. 15.
    Kaneko, A., Kaneita, Y., Yokoyama, E., Miyake, T., Harano, S., Suzuki, K., et al. (2008). Smoking trends before, during, and after pregnancy among women and their spouses. Pediatrics International, 50(3), 367–375.PubMedCrossRefGoogle Scholar
  16. 16.
    Kendzor, D. E., Businelle, M. S., Costello, T. J., Castro, Y., Reitzel, L. R., Vidrine, J. I., et al. (2010). Breast feeding is associated with postpartum smoking abstinence among women who quit smoking due to pregnancy. Nicotine & Tobacco Research, 12(10), 983–988.CrossRefGoogle Scholar
  17. 17.
    Weiser, T. M., Lin, M., Garikapaty, V., Feyerharm, R. W., Bensyl, D. M., & Zhu, B. P. (2009). Association of maternal smoking status with breastfeeding practices: Missouri, 2005. Pediatrics, 124(6), 1603–1610.PubMedCrossRefGoogle Scholar
  18. 18.
    U.S. Department of health and Human Services. Women and smoking: A report of the Surgeon Genaral. (2001). Atlanta. GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.Google Scholar
  19. 19.
    Bottorff, J. L., Oliffe, J., Kalaw, C., Carey, J., & Mroz, L. (2006). Men’s constructions of smoking in the context of women’s tobacco reduction during pregnancy and postpartum. Social Science and Medicine, 62, 3096–3108.PubMedCrossRefGoogle Scholar
  20. 20.
    Hensley Alford, S. M., Lappin, R. E., Peterson, L., & Johnson, C. C. (2009). Pregnancy associated smoking behavior and six year postpartum recall. Maternal and Child Health Journal, 13(6), 865–872.PubMedCrossRefGoogle Scholar
  21. 21.
    Wen, L. M., Baur, L. A., Rissel, C., Wardle, K., Alperstein, G., & Simpson, J. M. (2007). Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: A home-based randomised controlled trial (Healthy Beginnings Trial). BMC Public Health, 7, 76.PubMedCrossRefGoogle Scholar
  22. 22.
    Centre for Epidemiology and Research. (2006). 2006 report on Adult Health from New South Wales Population Health Survey. Australia: NSW Department of Health.Google Scholar
  23. 23.
    StataCorp: Stata Statistical Software: Release 10. (2007). Colleague Station, TX: StataCorp LP.Google Scholar
  24. 24.
    Greenland, S., & Finkle, W. D. (1995). A critical look at methods for handling missing covariates in epidemiologic regression analyses. American Journal of Epidemiology, 142(12), 1255–1264.PubMedGoogle Scholar
  25. 25.
    Jones, M. P. (1996). Indicator and stratification methods for missing explanatory variables in multiple linear regression. Journal of the American Statistical Association, 91(433), 222–230.CrossRefGoogle Scholar
  26. 26.
    Mullen, P. D. (2004). How can more smoking suspension during pregnancy become lifelong abstinence? Lessons learned about predictors interventions and gaps in our accumulated knowledge. Nicotine & Tobacco Research, 6(S2), S217–S238.CrossRefGoogle Scholar
  27. 27.
    Blackburn, C., Bonas, S., Spencer, N., Dolan, A., Coe, C., & Moy, R. (2005). Smoking behaviour change among fathers of new infants. Social Science and Medicine, 61(3), 517–526.PubMedCrossRefGoogle Scholar
  28. 28.
    Aveyard, P., Lawrence, T., Evans, O., & Cheng, K. K. (2005). The influence of in-pregnancy smoking cessation programmes on partner quitting and women’s social support mobilization: A randomized controlled trial. BMC Public Health, 5, 80.PubMedCrossRefGoogle Scholar
  29. 29.
    Gage, J. D., & Kirk, R. (2002). First-time fathers: Perceptions of preparedness for fatherhood. Canadian Journal of Nursing Research, 34(4), 15–24.PubMedGoogle Scholar
  30. 30.
    Nafstad, P., Botten, G., & Hagen, J. (1996). Partner’s smoking: A major determinant for changes in women’s smoking behaviour during and after pregnancy. Public Health, 110, 379–385.PubMedCrossRefGoogle Scholar
  31. 31.
    Brown, H., & Prescott, R. (2006). Applied mixed models in medicine (2nd ed.). Chichester, West Sussex, England: Wiley.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Huilan Xu
    • 1
  • Li Ming Wen
    • 1
    • 2
  • Chris Rissel
    • 2
  • Louise A. Baur
    • 2
    • 3
  1. 1.Health Promotion Service, South Western Sydney and Sydney Local Health DistrictsCamperdownAustralia
  2. 2.School of Public Health, Sydney Medical SchoolUniversity of SydneySydneyAustralia
  3. 3.Discipline of Paediatrics and Child Health, Sydney Medical SchoolUniversity of SydneySydneyAustralia

Personalised recommendations