Skip to main content

Advertisement

SpringerLink
Log in

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

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

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.

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. Edwards, N., & Sims-Jones, N. (1998). Smoking and smoking relapse during pregnancy and postpartum: Results of a qualitative study. Birth, 25(2), 94–100.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. 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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  12. Giglia, R. C., Binns, C. W., & Alfonso, H. (2006). Maternal cigarette smoking and breastfeeding duration. Acta Paediatrica, 95(11), 1370–1374.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. 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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. StataCorp: Stata Statistical Software: Release 10. (2007). Colleague Station, TX: StataCorp LP.

  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.

    PubMed  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  29. Gage, J. D., & Kirk, R. (2002). First-time fathers: Perceptions of preparedness for fatherhood. Canadian Journal of Nursing Research, 34(4), 15–24.

    PubMed  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  31. Brown, H., & Prescott, R. (2006). Applied mixed models in medicine (2nd ed.). Chichester, West Sussex, England: Wiley.

    Book  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

  1. Health Promotion Service, South Western Sydney and Sydney Local Health Districts, Level 9, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia

    Huilan Xu & Li Ming Wen

  2. School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW, 2050, Australia

    Li Ming Wen, Chris Rissel & Louise A. Baur

  3. Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, NSW, 2050, Australia

    Louise A. Baur

Authors
  1. Huilan Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Li Ming Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chris Rissel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Louise A. Baur
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Li Ming Wen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Xu, H., Wen, L.M., Rissel, C. et al. Smoking Status and Factors Associated with Smoking of First-Time Mothers During Pregnancy and Postpartum: Findings from the Healthy Beginnings Trial. Matern Child Health J 17, 1151–1157 (2013). https://doi.org/10.1007/s10995-012-1108-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-012-1108-6

Keywords

Search

Navigation