Preventing postpartum smoking relapse among diverse low-income women: A randomized clinical trial

Reitzel, Lorraine R.; Vidrine, Jennifer Irvin; Businelle, Michael S.; Kendzor, Darla E.; Costello, Tracy J.; Li, Yisheng; Daza, Patricia; Mullen, Patricia Dolan; Velasquez, Mary M.; Cinciripini, Paul M.; Cofta-Woerpel, Ludmila; Wetter, David W.

doi:10.1093/ntr/ntq001

Cited by 73 publications

(95 citation statements)

References 70 publications

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“…The criteria for inclusion in the particular risk set were the following: five or more cigarettes per day in the three months before or in pregnancy for smoking; seven drinks per week or three or more per day during the six months prior to or in pregnancy for alcohol; any marijuana use during the six months prior to or in pregnancy for marijuana; or any cocaine use in the six months prior to or during pregnancy. The five cigarette minimum was based on the smoking literature in perinatal women (Cnattingius, 2004;McBride et al, 1992;Reitzel et al, 2010;Tong et al, 2008), and used the minimum amount, which allowed us to capture the majority of smokers. For alcohol the National Institute on Alcohol Abuse and Alcoholism definition for at risk drinking in women was used (National Institute on Alcohol Abuse and Alcoholism, 2014).…”

Section: Development Of Substance Use Risk Sets For Analysismentioning

confidence: 99%

Perinatal substance use: A prospective evaluation of abstinence and relapse

Forray

Merry

Lin

et al. 2015

Drug and Alcohol Dependence

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Background-Substance use decreases in pregnancy but little prospective data are available on the rates of abstinence and relapse for specific substances. This study compared rates of abstinence in pregnancy and relapse postpartum for nicotine cigarettes, alcohol, marijuana, and cocaine.Methods-Data from 152 women drawn from a randomized controlled trial comparing psychological treatments for substance use in pregnancy were analyzed. Self-reports of substance use and urine for toxicology testing throughout pregnancy and 3-months, 12-months and 24-months post-delivery were collected. Multivariate Cox models were used to compare rates of abstinence and relapse across substances.Results-In pregnancy, 83% of all women achieved abstinence to at least one substance. The mean (SE) days to abstinence was 145.81 (9.17), 132.01 (6.17), 151.52 (6.24), and 148.91 (7.68) for cigarettes, alcohol, marijuana and cocaine, respectively. Participants were more likely to achieve abstinence from alcohol (HR 7.24 (95% CI 4.47-11.72), marijuana (HR 4.06; 95% CI 1.87-6.22), and cocaine (HR 3.41; 95% CI 2.53-6.51), than cigarettes. Postpartum, 80% of women © 2015 Published by Elsevier Ltd.Please address correspondence to Ariadna Forray at: 40 Temple Street, Suite 6B, New Haven, Connecticut, 06510 USA Fax: (203) 764-6766; ariadna.forray@yale.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Contributors:Drs. Yonkers and Ruger were responsible for the conduct of the study. Drs. Forray, Yonkers, Lin and Mr. Merry were responsible for the statistical analyses and interpretation of the data. Dr. Forray was responsible for initial draft of the manuscript, with contributions from Dr. Yonkers and Mr. Merry. Drs. Forray, Yonkers, Ruger, Lin, and Mr. Merry were responsible for critical review and editing of the manuscript. Conflict of Interest:In the past year, Dr. Yonkers received royalties from Up To Date, the content of which has no relationship to this project. Drs. Forray, Ruger, Lin and Mr. Merry have nothing to disclose. Conclusions-Pregnancy-related abstinence rates were high for all substances except cigarettes. Postpartum relapse was common, with cocaine using women being less likely to relapse after attaining abstinence compared to women using cigarettes, alcohol or marijuana. HHS Public Access

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Section: Development Of Substance Use Risk Sets For Analysismentioning

confidence: 99%

Perinatal substance use: A prospective evaluation of abstinence and relapse

Forray

Merry

Lin

et al. 2015

Drug and Alcohol Dependence

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“…Trait hostility consistently predicts higher smoking rates in both men and women (Lipkus et al, 1994;Siegler et al, 1992;Whiteman et al, 1997). In contrast to the large number of studies focusing on the association between maternal depression/ stress and smoking during pregnancy (Bullock et al, 2001;Businelle et al, 2010;Cinciripini et al, 2010;Ludman et al, 2000;Munafò et al, 2008;Reitzel et al, 2010), few investigated anger, hostility, or aggression among pregnant smokers. One exception is the study by Schuetze et al (2008), which indicated that pregnant smokers report higher hostile mood and maternal hostility.…”

mentioning

confidence: 99%

Anger, Hostility, and Aggression as Predictors of Persistent Smoking During Pregnancy

Eiden¹,

Leonard²,

Colder³

et al. 2011

J. Stud. Alcohol Drugs

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ABSTRACT. Objective:We examined the role of anger, hostility, and aggression, in addition to depression and stress, in predicting persistent smoking during pregnancy in a low-income sample. Method: The sample consisted of 270 pregnant women (189 smokers, 81 nonsmokers) recruited into a prospective study of prenatal cigarette exposure in the fi rst trimester. Persistent pregnancy smoking was defi ned as self-reporting daily smoking in at least two trimesters, a positive salivary cotinine level in at least two trimesters, or infant meconium positive for nicotine and/ or its metabolites. Results: Persistent smokers reported higher prenatal stress and negative affect symptoms (depression, anger, hostility, aggression) than nonpersistent smokers or nonsmokers. However, in the context of model testing, maternal anger, hostility, and aggression each accounted for unique variance in persistent smoking, whereas symptoms of depression and stress did not. Conclusions: To date, interventions for pregnant low-income smokers have been largely ineffective. The current results suggest that anger management interventions may be particularly effective for low-income persistent pregnant smokers and may be more likely to prevent relapse than depression-focused interventions. (J. Stud. Alcohol Drugs, 72, 926-932, 2011)

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“…[40] In this pilot, 23% quit spontaneously after finding out they were pregnant, which was consistent with the literature. [23,38] Unfortunately, most spontaneous quitters return to smoking during postpartum. [16,23,26,41] The majority resume smoking within six months, [10,25] and this increases to as much as 80% within one year after delivery.…”

Section: Discussionmentioning

confidence: 99%

“…[23,38] Unfortunately, most spontaneous quitters return to smoking during postpartum. [16,23,26,41] The majority resume smoking within six months, [10,25] and this increases to as much as 80% within one year after delivery. [11] The rate of smoking relapse for low-income women is higher than all pregnant women.…”

Section: Discussionmentioning

confidence: 99%

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Smoking behaviors and abstinence in low-income pregnant women

Kessler

Alverson

2016

JNEP

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Background: Despite efforts to educate individuals about the hazards of smoking, pregnant women continue to smoke. In the literature, there is less evidence about successful abstinence strategies for low-income women. The purpose of this pilot study was to assess smoking behaviors and factors that support smoking abstinence in low-income pregnant women. Methods: Using a longitudinal design, quantitative and qualitative data were collected from pregnant women at a low-income community prenatal clinic. Based on the Transtheoretical model, all subjects received information about the harmful effects of smoking and secondhand exposure, while current smokers were given a "quit kit" and contacted up to one year post-delivery to evaluate smoking behaviors. Results: All subjects (N = 135) ranged in age from 18 to 41; 75% were not married; 78% had household incomes < $30,000; and the majority were African American (40%). Fifty-five (40.7%) never smoked while 77(57%) had a smoking history, of these 18(23%) were spontaneous quitters. Data indicated that 36% reported smoking during pregnancy, with the majority in pre-contemplation. After one year, 18% of current smokers quit. Conclusions: Without a specific plan, the majority were unable to successfully abstain. Rate of abstinence may have been further influenced because subjects began smoking at an early age and were unsuccessful at previous quit attempts. Providers must continue to educate pregnant women but also evaluate strategies that require few provider visits, are cost effective, focus on relapse prevention, and can successfully influence smoking abstinence in low-income pregnant women.

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Preventing postpartum smoking relapse among diverse low-income women: A randomized clinical trial

Cited by 73 publications

References 70 publications

Perinatal substance use: A prospective evaluation of abstinence and relapse

Perinatal substance use: A prospective evaluation of abstinence and relapse

Anger, Hostility, and Aggression as Predictors of Persistent Smoking During Pregnancy

Smoking behaviors and abstinence in low-income pregnant women

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