Objectives: The objective of this research was to explore prenatal smoking behaviors among Black women attending prenatal clinics. Despite the racial disparities in poor pregnancy outcomes, and the well-known association of smoking with harmful outcomes, little research has been conducted about prenatal smoking among Black women. Methods: Women were enrolled in the study and interviewed at the time of the first prenatal visit. The interview contained items to assess prenatal smoking and cessation, depressive symptoms, demographic factors, and beliefs about smoking. Reports of smoking cessation were verified using urinary cotinine. Results: The sample consisted of 811 Black women. Fourteen percent of the women were self-reported smokers, 12.6% reported cessation and 73% were nonsmokers. Twenty percent of the self-reported quitters had elevated cotinine; when these women were reclassified, 17% of the women were smokers. Factors associated with smoking in logistic regression analysis included elevated maternal depressive symptoms (OR = 1.7, 95% CI: 1.1–2.6), maternal age 20 years or older (OR = 1.94; 95% CI: 1.1, 3.3), less than a high school education (OR = 2.2; 95% CI: 1.2, 3.8), unmarried/not living with a partner (OR = 1.9; 95% CI: 1.0, 3.6), and allowing smoking in the home (OR = 5.5; 95% CI: 3.4, 8.6). Conclusions: The prevalence of maternal prenatal smoking was much higher among women in this sample than has been previously reported. The rate of nondisclosure of smoking among self-reported quitters was also high. Maternal behavioral (allowing smoking in the home) and psychosocial factors (depressive symptoms) were associated with prenatal smoking.
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References
Hamilton BE, Martin JA, Sutton PD. Births: Preliminary Data for 2002. National Vital Statistics Reports; Vol 51 No. 11. National Center for Health Statistics, Hyattsville, MD. 2003.
Martin JA, Hamilton BE, Ventura SJ, Menacker F, Park MM. Births: Final Data for 2000. National Vital Statistics Reports; Vol 50 No 5. National Center for Health Statistics, Hyattsville, MD. 2002.
Cnattingius S. The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine Tobacco 2004;6:S125–S140.
National Center for Health Statistics. Health, United States, 2002. With Chartbook on Trends in the Health of Americans. Hyattsville, Maryland, 2002, p. 93.
Borrelli B, Bock B, King T, Pinto B, Marcus BH. The impact of depression on smoking cessation in women. Am J Prev Med 1996;12:378–87.
Orr ST, Miller CA. Maternal depressive symptoms and the risk of poor pregnancy outcome. Review of the literature and preliminary findings. Epidemiol Rev 1995;17:165–71.
Weissman MM. Advances in psychiatric epidemiology: Rates and risks for major depression. Am J Public Health 1987;77:445–51.
Weissman MM, Olfson M. Depression in women: Implications for health care research. Science 1995;269:799–801.
Zuckerman B, Amaro H, Bauchner H, Cabral H. Depressive symptoms during pregnancy: Relationship to poor health behaviors. Am J Obstet Gynecol 1989;160:1107–11.
Zhu SH, Valbo A. Depression and smoking during pregnancy. Addict Behav 2002;27:649–58.
Pritchard CW. Depression and smoking in pregnancy in Scotland. J Epid Comm Hlth 1994;48:377–82.
Melvin C, Tucker P, and the Smoke-Free Families Common Evaluation Measures for Pregnancy and Smoking Cessation Projects Working Group. Measurement and definition for smoking cessation intervention research: The smoke-free families experience. Tobacco Control 2000;9:iii87–iii90.
Melvin CL, Dolan-Mullen P, Windsor RA, Whiteside HP Jr, Goldenberg RL. Recommended cessation counseling for pregnant women who smoke: a review of the evidence. Tobacco Control 2000;9:iii80–iii84.
Klebanoff MA, Levine RJ, Clemens JD, DerSimonian R, Wilkins DG. Serum cotinine concentration and self-reported smoking during pregnancy. Am J Epidemiol 1998;148:259–62.
Klebanoff MA, Levine RJ, Morris CD, Hauth JC, Sibai BM, Ben C, Catalano P, Wilkins DG. Accuracy of self-reported cigarette smoking among pregnant women in the 1990s. Paediatr Perinatal Epidemiol 2001;15:140–3.
Radloff LS. The CES-D Scale; A self-report depression scale for research in the general population. Appl Psychol Measure 1977;1:385–401.
Orr ST, James SA, Prince CB. Maternal prenatal depressive symptoms and spontaneous preterm births among African-American women in Baltimore, Maryland. Am J Epidemiol 2002;156:797–802.
Weissman MM, Sholomskas D, Pottenger M, Prusoff BA, Locke BZ. Assessing depressive symptoms in five psychiatric populations: A validation study. Am J Epidemiol 1997;106:203–14.
Husaini BA, Neff JA, Harrington JB, Hughes MD. Depression in rural communities: Validating the CES-D scale. J Commun Psychol 1980;8:20–7.
Markush RE, Favero RV. Epidemiologic assessment of stressful life events, depressed mood, and psychophysiological symptoms—a preliminary report. In: Dohrenwend BS, Dohrenwend BP, editors. Stressful Life Events: Their Nature and Effects. Wiley, New York, NY. 1974:171–90.
Public Health Services Office of the Assistant Secretary for Health. Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington, DC: US Government Printing Office 2000, p. 380.
Blazer DG, Kessler RC, McGonagle KA, Swartz MS. The prevalence and distribution of major depression in a national community sample: The national comorbidity survey. Am J Psychiatry 1994;151:979–86.
ACKNOWLEDGMENTS
This research was supported by the Robert Wood Johnson Foundation, Smoke-Free Families, Phase II, grant number 040679. The authors gratefully acknowledge the support of the Foundation, as well as the assistance of staff at the Foundation and the Smoke-Free Families program office. We also wish to thank Annette Eubanks for conducting the study interviews, and Suzanne Kelly for assistance with data management.
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Orr, S.T., Newton, E., Tarwater, P.M. et al. Factors Associated with Prenatal Smoking Among Black Women in Eastern North Carolina. Matern Child Health J 9, 245–252 (2005). https://doi.org/10.1007/s10995-005-0010-x
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DOI: https://doi.org/10.1007/s10995-005-0010-x