Skip to main content

Advertisement

SpringerLink
Log in

Do Risk Factors for Post-partum Smoking Relapse Vary According to Marital Status?

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

We aimed to examine associations between factors readily obtainable in health care settings and post-partum smoking relapse in women of differing marital status. We analysed data on 1,829 mothers in the Millennium Cohort Study who reported quitting smoking during their pregnancy using multivariate logistic regression. We analysed single, married and cohabiting women separately. Fifty-seven percent of mothers who quit during pregnancy had relapsed at 9 months. The risk of relapse was highest for single women, followed by cohabiting, then married women. Higher parity and not managing financially were associated with relapse for single women. For married women the greatest risk of relapse was associated with having a partner who also relapsed. Women whose husbands continued to smoke had an increased risk of relapse but those whose husbands had sustained a quit were protected. Other significant risk factors were not breastfeeding, having other children and drinking at moderate frequencies. A similar pattern was seen for cohabiting women, except that having a partner who quit but then relapsed did not appear to confer an additional risk. Drinking at moderate intervals (only) was associated with relapse but breastfeeding and parity were not. The association between married couple relapse was not evident when only the husband’s smoking status during the pregnancy was considered, indicating that partner follow-up is important post-partum. Risk factors for relapse appear to differ according to marital status. A ‘one size fits all’ package of post-partum relapse prevention is unlikely to be an appropriate intervention strategy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bolling, K., Grant, C., Hamlyn, B., et al. (2007). Infant feeding survey 2005. London: The Information Centre.

    Google Scholar 

  2. NHS IC. (2009). Statistics on NHS stop smoking services: England. April 2008–March 2009. London.

  3. Hajek, P., Stead, L. F., West, R. et al. (2009). Relapse prevention interventions for smoking cessation. The Cochrane Database of Systematic Reviews. 1, CD003999.

  4. BMA. (2004). Smoking and reproductive life: The impact of smoking on reproductive and child health. London: Board of Science and Education & Tobacco Control Resource Center.

  5. DiClemente, C. C., Dolan-Mullen, P., & Windsor, R. A. (2000). The process of pregnancy smoking cessation: Implications for interventions. Tobacco Control, 9(Suppl 3), III16–III21.

    PubMed  Google Scholar 

  6. Myers, K., West, O., & Hajek, P. (2009). Rapid review of interventions to prevent relapse in pregnant ex-smokers. London: Report to the National Institute for Health and Clinical Excellence.

  7. Pletsch, P. K. (2006). A model for postpartum smoking resumption prevention for women who stop smoking while pregnant. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35(2), 215–222.

    Article  PubMed  Google Scholar 

  8. Severson, H. H., Andrews, J. A., Lichtenstein, E., et al. (1995). Predictors of smoking during and after pregnancy: A survey of mothers of newborns. Preventive Medicine, 24(1), 23–28.

    Article  PubMed  CAS  Google Scholar 

  9. Severson, H. H., Andrews, J. A., Lichtenstein, E., et al. (1997). Reducing maternal smoking and relapse: Long-term evaluation of a pediatric intervention. Preventive Medicine, 26(1), 120–130.

    Article  PubMed  CAS  Google Scholar 

  10. Letourneau, A. R., Sonja, B., Mazure, C. M., et al. (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.

    Article  PubMed  Google Scholar 

  11. Ratner, P. A., Johnson, J. L., Bottorff, J. L., et al. (2000). Twelve-month follow-up of a smoking relapse prevention intervention for postpartum women. Addictive Behaviors, 25(1), 81–92.

    Article  PubMed  CAS  Google Scholar 

  12. Bottorff, J. L., Oliffe, J., Kalaw, C., et al. (2006). Men’s constructions of smoking in the context of women’s tobacco reduction during pregnancy and postpartum. Social Science and Medicine, 62(12), 3096–3108.

    Article  PubMed  Google Scholar 

  13. Oliffe, J. L., Bottorff, J. L., Johnson, J. L., et al. (2010). Fathers: Locating smoking and masculinity in the postpartum. Qualitative Health Research, 20(3), 330–339.

    Article  PubMed  Google Scholar 

  14. Gage, J. D., Everett, K. D., & Bullock, L. (2007). A review of research literature addressing male partners and smoking during pregnancy. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 36(6), 574–580.

    Article  PubMed  Google Scholar 

  15. McBride, C. M., Curry, S. J., Grothaus, L. C., et al. (1998). Partner smoking status and pregnant smoker’s perceptions of support for and likelihood of smoking cessation. Health Psychology, 17(1), 63–69.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  17. Kiernan, K., & Pickett, K. E. (2006). Marital status disparities in maternal smoking during pregnancy, breastfeeding and maternal depression. Social Science and Medicine, 63(2), 335–346.

    Article  PubMed  Google Scholar 

  18. Kiernan, K. E. (2004). Cohabitation and divorce across nations and generations. In P. L. Chase-Lansdale, K. E. Kiernan, & R. Friedman (Eds.), Human development across lives and generations: The potential for change. New York: Cambridge University Press.

    Google Scholar 

  19. NICE. (2010). Public health guidance 26: How to stop smoking in pregnancy and following childbirth. London: National Institute for Health and Clinical Excellence.

  20. Dex, S., & Joshi, H. (2004). Millennium cohort study first survey: A user’s guide to initial findings. London: Institute of Education, University of London.

    Google Scholar 

  21. Plewis, I., Calderwood ,L., Hawkes, D. et al. (2004). Millennium cohort study first survey: Technical report on sampling. London: Centre for Longitudinal Studies.

  22. ONS. (2005). The National statistics socio-economic classification user manual. Basingstoke: Palgrave Macmillan.

  23. Kelly, Y., Bartley, M., Schoon, I., et al. (2004). Parents’ health. London: Centre for Longitudinal Studies.

    Google Scholar 

  24. Park, E. R., Chang, Y., Quinn, V., et al. (2009). The association of depressive, anxiety, and stress symptoms and postpartum relapse to smoking: a longitudinal study. Nicotine & Tobacco Research, 11(6), 707–714.

    Article  Google Scholar 

  25. Wakschlag, L. S., Pickett, K. E., Middlecamp, M. K., et al. (2003). Pregnant smokers who quit, pregnant smokers who don’t: Does history of problem behavior make a difference? Social Science and Medicine, 56(12), 2449–2460.

    Article  PubMed  Google Scholar 

  26. Solomon, L. J., Higgins, S. T., Heil, S. H., et al. (2007). Predictors of postpartum relapse to smoking. Drug and Alcohol Dependence, 90(2–3), 224–227.

    Article  PubMed  Google Scholar 

  27. Valanis, B., Lichtenstein, E., Mullooly, J. P., et al. (2001). Maternal smoking cessation and relapse prevention during health care visits. American Journal of Preventive Medicine, 20(1), 1–8.

    Article  PubMed  CAS  Google Scholar 

  28. Graham, H., & Owen, L. (2003). Are there socioeconomic differentials in under-reporting of smoking in pregnancy? Tobacco Control, 12(4), 434.

    Article  PubMed  CAS  Google Scholar 

  29. Van’t Hof, S. M., Wall, M. A., Dowler, D. W., et al. (2000). Randomised controlled trial of a postpartum relapse prevention intervention. Tobacco Control, 9(Suppl 3), III64–III66.

    PubMed  Google Scholar 

  30. Park, E. R., Chang, Y., Quinn, V. P., et al. (2009). Perceived support to stay quit: What happens after delivery? Addictive Behaviors, 34(12), 1000–1004.

    Article  PubMed  Google Scholar 

  31. Reitzel, L. R., Vidrine, J. I., Li, Y., et al. (2007). The influence of subjective social status on vulnerability to postpartum smoking among young pregnant women. American Journal of Public Health, 97(8), 1476–1482.

    Article  PubMed  Google Scholar 

  32. Roske, K., Schumann, A., Hannover, W., et al. (2008). Postpartum smoking cessation and relapse prevention intervention: A structural equation modeling application to behavioral and non-behavioral outcomes of a randomized controlled trial. The Journal of Health Psychology, 13(4), 556–568.

    Article  CAS  Google Scholar 

  33. Curry, S. J., McBride, C., Grothaus, L., et al. (2001). Motivation for smoking cessation among pregnant women. Psychology of Addictive Behaviors, 15(2), 126–132.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors are funded by an NIHR CLAHRC implementation grant. KEP is supported by an NIHR Career Scientist Award, and KB by an NIHR Career Development Fellowship. This paper presents independent research commissioned by the National Institute for Health Research (NIHR) under the CLAHRC programme. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The authors would like to thank the health visitors and midwives in the CLAHRC clinical networks for raising the idea, Lesley Fairley for commenting on the initial statistical analysis and the peer reviewers who helped us improve this manuscript.

Author information

Authors and Affiliations

  1. Department of Health Sciences, University of York, Seebohm Rowntree Building, Area 4, York, YO10 5DD, UK

    Stephanie L. Prady, Karen Bloor & Kate E. Pickett

  2. Department of Social Policy and Social Work, University of York, Seebohm Rowntree Building, York, YO10 5DD, UK

    Kathleen Kiernan

Authors
  1. Stephanie L. Prady
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kathleen Kiernan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karen Bloor
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kate E. Pickett
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephanie L. Prady.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Prady, S.L., Kiernan, K., Bloor, K. et al. Do Risk Factors for Post-partum Smoking Relapse Vary According to Marital Status?. Matern Child Health J 16, 1364–1373 (2012). https://doi.org/10.1007/s10995-011-0899-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-011-0899-1

Keywords

Search

Navigation