A Reexamination of Smoking Before, During, and After Pregnancy
Robert S. Kahn, MD, MPH,
Laura Certain, BA and
Robert C. Whitaker, MD, MPH
Robert S. Kahn and Robert C. Whitaker are with the Division of General and Community Pediatrics, Childrens Hospital Medical Center, Cincinnati, Ohio. Laura Certain is with the University of Washington School of Medicine, Seattle, Wash.
Correspondence: Requests for reprints should be sent to Robert S. Kahn, MD, MPH, Division of General and Community Pediatrics, Childrens Hospital Medical Center, TCHRF 6549, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (e-mail: robert.kahn{at}chmcc.org).
Objectives. This study examined the patterns and correlatesof maternal smoking before, during, and after pregnancy.
Methods. We examined socioeconomic, demographic, and clinicalrisk factors associated with maternal smoking in a nationallyrepresentative cohort of women (n = 8285) who were surveyed17 ± 5 months and again 35 ± 5 months after delivery.
Results. Smoking rates among women with a college degree decreased30% from before pregnancy to 35 months postpartum but did notchange among the least educated women. Risk factors clustered,and a gradient linked the number of risk factors (0, 2, 4) tothe percentage smoking (6%, 31%, 58%, P < .0001).
Conclusions. The period of pregnancy and early parenthood isassociated with worsening education-related disparities in smokingas well as substantial clustering of risk factors. These observationscould influence the targeting and design of maternal smokinginterventions.
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