Quitting Smoking before and after Pregnancy: Study Methods and Baseline Data from a Prospective Cohort Study

Abstract

Smoking during pregnancy and postpartum remains an important public health problem. No known prior study has prospectively examined mutual changes in risk factors and women’s smoking trajectory across pregnancy and postpartum. The objective of this study was to report methods used to implement a prospective cohort (Msgs4Moms), present participant baseline characteristics, and compare our sample characteristics to pregnant women from national birth record data. The cohort study was designed to investigate smoking patterns, variables related to tobacco use and abstinence, and tobacco treatment quality across pregnancy through 1-year postpartum. Current smokers or recent quitters were recruited from obstetrics clinics. Analyses included Chi-square and independent sample t-tests using Cohen’s d. A total of 62 participants (41 smokers and 21 quitters) were enrolled. Participants were Black (45.2%), White (35.5%), and multiracial (19.3%); 46.8% had post-secondary education; and most were Medicaid-insured (64.5%). Compared with quitters, fewer smokers were employed (65.9 vs 90.5%, Cohen’s d = 0.88) and more reported financial strain (61.1% vs 28.6%; Cohen’s d = 0.75). Women who continue to smoke during pregnancy cope with multiple social determinants of health. Longitudinal data from this cohort provide intensive data to identify treatment gaps, critical time points, and potential psychosocial variables warranting intervention.

Smoking cessation intervention in puerperium: A systematic review and meta-analysis

“…Anxiety, postpartum depression, and negative emotions [18,21] Alcohol consumption [21] Strong cravings for cigarettes (increased nicotine dependence) [21] The absence of assistance from medical professionals [21] Staying in a place where there is smoke [21] Returning to work (colleagues who are smokers) [21] Education and education level [28] The low income [18] Weight gain [35] The few attempts to quit smoking [30,39] The temporary cessation of smoking [30,39] Not being worried about the negative health effects of smoking [39] The significant increase in the number of pregnancies and children [39] The presence of a smoking partner in the home environment [18,21] Smoking before and after childbirth [39] Not wanting another pregnancy [39] The duration of abstinence from smoking [30] the Edinburgh Postnatal Depression Scale at the end of pregnancy can help determine the success of a postpartum smoking relapse prevention intervention 26,30 .…”

“…Some of the studies [18][19][20] identified by this systematic review implement a smoking cessation intervention program during the postpartum period using technology [text messages, emails, smartphone applications, videography, telephone counseling lines for smoking cessation, etc.) in order to facilitate participants and urge them to continue the cessation effort by making the necessary meetings (followup)] or answering their questions from wherever they were.…”

“…Health professionals dealing with the perinatal period, while asking about tobacco use in the early stages of pregnancy during history-taking, do not provide systematic counseling about smoking cessation throughout the perinatal period, and women who want to try to change their smoking habit do not find the appropriate supporting framework 18 .…”