Changes in Multiple and Different Tobacco Product Use Behaviors in Women Before and During Pregnancy: An Analysis of Longitudinal Population Assessment of Tobacco and Health Data

Abstract

Introduction:Changes in tobacco use behaviors among women with respect to pregnancy are expected to be significant and dynamic, with a strong desire for smoking cessation, diversification of tobacco products, and perceived relative safety on non-cigarette tobacco products. This study aims to illustrate how multiple and different tobacco use behaviors change before and during pregnancy.Methods: Data were extracted from 864 pregnant, nationally representative U.S. women, who were prospectively followed with the Population Assessment of Tobacco and Health study between 2013 and 2017. Smoking statuses were defined based on the number and type of seven different tobacco products under current use. Differences in maternal characteristics were investigated in relation to tobacco-cessation statuses during pregnancy. Weighted percentages and 95% CIs were calculated.Results: Only 50.4% of pre-pregnancy tobacco users achieved complete abstinence with varying rates of cessation, depending on the number and type of products used pre-pregnancy. The lowest cessation rates were observed among pre-pregnancy poly-tobacco users (23.3%) and conventional cigarette smokers (45.5%). During pregnancy, 11.3% and 2.8% of women reported smoking cigarettes and e-cigarettes, respectively. Persistent tobacco users during pregnancy were more likely to be white, older, and have non-private or no medical insurance (all p<0.05). Conclusions:This study demonstrates a widespread prenatal tobacco use and low rates of complete cessation in major subgroups of tobacco users. Current findings on the concurrent use of multiple products and non-cigarette tobacco products highlight the urgent need for further research and comprehensive public health intervention for smoking cessation during pregnancy.

Exposure-response analysis of the association of maternal smoking and use of electronic cigarettes (vaping) in relation to preterm birth and small-for-gestational-age in a national US sample, 2016-2018

“…14 Among 864 participants in the Population Assessment of Tobacco and Health study (2013-2017), 2.8% of women reported vaping during pregnancy. 15 However, none of these recent studies were based on nationally representative samples of pregnant women, accounted for dual use, or considered timing in pregnancy, and none of the studies accounted for errors in self-report.…”

Use and co-use of tobacco and cannabis before, during, and after pregnancy: A longitudinal analysis of waves 1–5 of the Population Assessment of Tobacco and Health (PATH) study.

“…The present study included five waves of PATH Study adult response data, ranging from Wave 1 (W1; 2013-2014), Wave 2 (W2; -20152015 to Wave 5 (W5;. Following a similar analytic strategy to previous studies which have utilized PATH pregnancy data (Cohn et al, 2023;Kim, 2020), in order to assess prepregnancy, pregnancy, and postpartum data, three separate cohorts using three consecutive waves were stacked in a single analysis (W1-W2-W3, W2-W3-W4, W3-W4-W5). The analytic sample was restricted to women who (a) were not currently pregnant at prepregnancy or postpartum, (b) reported a current pregnancy during the middle wave, (c) endorsed a live birth at the wave following pregnancy, and (d) had complete data in all three waves in each cohort.…”

“…The goal of the present study was to examine patterns of tobacco-only use, cannabis-only use, and co-use of tobacco and cannabis before, during, and after pregnancy utilizing data drawn from Waves 1–5 of the Population Assessment of Tobacco and Health (PATH) Study. Prior research using data from the PATH Study has examined use of nicotine/tobacco and cannabis among pregnant samples (e.g., Beck et al, 2021; Kim, 2020; Nighbor et al, 2018), and one initial study examined tobacco use as a predictor of adverse birth outcomes among PATH respondents during and after pregnancy (Cohn et al, 2023); however, none have examined co-use of tobacco and cannabis or included prospective prepregnancy data. Our first goal was to examine the prevalence of tobacco and cannabis use and co-use at prepregnancy, pregnancy, and postpartum time points.…”