Receiving Versus Being Denied an Abortion and Subsequent Tobacco Use


The negative health consequences of tobacco use are well documented. Some research finds women receiving abortions are at increased risk of subsequent tobacco use. This literature has methodological problems, most importantly, inappropriate comparison groups. This study uses data from the Turnaway Study, a longitudinal study of women who all sought, but did not all receive, abortions at 30 facilities across the United States. Participants included women presenting just before an abortion facility’s gestational age limit who received abortions (Near Limit Abortion Group, n = 452), just after the gestational limit who were denied abortions (Turnaways, n = 231), and who received first trimester abortions (First Trimester Abortion Group, n = 273). This study examined the association between receiving versus being denied an abortion and subsequent tobacco use over 2-years. Trajectories of tobacco use over 2 years were compared using multivariate mixed effects regression. Women receiving abortion maintained their level of tobacco use over 2 years. Women denied abortion initially had lower levels of tobacco use than women receiving abortion, but increased their tobacco use from 1 week through 12–18 months post-abortion seeking and then decreased their use by 2 years post-abortion seeking. Baseline parity modified these associations. Receiving an abortion was not associated with an increase in tobacco use over time. Overall, women who carry unwanted pregnancies to term appear to demonstrate similar cessation and resumption patterns to other pregnant women.

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Components of this study were funded by the Wallace Alexander Gerbode Foundation, the William and Flora Hewlett Foundation, the David and Lucile Packard Foundation, and an anonymous foundation. The authors thank Rana Barar, Heather Gould and Sandy Stonesifer for study coordination and management; Janine Carpenter, Undine Darney, Ivette Gomez, Selena Phipps, Claire Schreiber and Danielle Sinkford for conducting interviews; Michaela Ferrari and Elisette Weiss for project support; and Jay Fraser, John Neuhaus, and Caitlin Gerdts for database and statistical assistance. Preliminary findings from this study were presented at the American Public Health Association Conference in San Francisco, CA in October 2012.

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Correspondence to Sarah C. M. Roberts.

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Roberts, S.C.M., Foster, D.G. Receiving Versus Being Denied an Abortion and Subsequent Tobacco Use. Matern Child Health J 19, 438–446 (2015).

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  • Pregnancy
  • Tobacco
  • Abortion