Smoking and quit attempts during pregnancy and postpartum: a longitudinal UK cohort

• Published in: BMJ open 2017-11, Vol.7 (11), p.e018746-e018746
• Main Authors: Cooper, Sue, Orton, Sophie, Leonardi-Bee, Jo, Brotherton, Emma, Vanderbloemen, Laura, Bowker, Katharine, Naughton, Felix, Ussher, Michael, Pickett, Kate E, Sutton, Stephen, Coleman, Tim
• Format: Article
• Language: English
• Subjects: Adult; England - epidemiology; Female; Gestational Age; Health risk assessment; Humans; Logistic Models; Longitudinal Studies; Motivation; Postpartum Period; Pregnancy; Self Report; Smoking; Smoking - epidemiology; Smoking and Tobacco; Smoking Cessation - statistics & numerical data; Systematic review; Womens health; Young Adult
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-018746

ObjectivesPregnancy motivates women to try stopping smoking, but little is known about timing of their quit attempts and how quitting intentions change during pregnancy and postpartum. Using longitudinal data, this study aimed to document women’s smoking and quitting behaviour throughout pregnancy and after delivery.DesignLongitudinal cohort survey with questionnaires at baseline (8–26 weeks’ gestation), late pregnancy (34–36 weeks) and 3 months after delivery.SettingTwo maternity hospitals in one National Health Service hospital trust, Nottingham, England.Participants850 pregnant women, aged 16 years or over, who were current smokers or had smoked in the 3 months before pregnancy, were recruited between August 2011 and August 2012.Outcome measuresSelf-reported smoking behaviour, quit attempts and quitting intentions.ResultsSmoking rates, adjusting for non-response at follow-up, were 57.4% (95% CI 54.1 to 60.7) at baseline, 59.1% (95% CI 54.9 to 63.4) in late pregnancy and 67.1% (95% CI 62.7 to 71.5) 3 months postpartum. At baseline, 272 of 488 current smokers had tried to quit since becoming pregnant (55.7%, 95% CI 51.3 to 60.1); 51.3% (95% CI 44.7 to 58.0) tried quitting between baseline and late pregnancy and 27.4% (95% CI 21.7 to 33.2) after childbirth. The percentage who intended to quit within the next month fell as pregnancy progressed, from 40.4% (95% CI 36.1 to 44.8) at baseline to 29.7% (95% CI 23.8 to 35.6) in late pregnancy and 14.2% (95% CI 10.0 to 18.3) postpartum. Postpartum relapse was lower among women who quit in the 3 months before pregnancy (17.8%, 95% CI 6.1 to 29.4) than those who stopped between baseline and late pregnancy (42.9%, 95% CI 24.6 to 61.3).ConclusionsMany pregnant smokers make quit attempts throughout pregnancy and postpartum, but intention to quit decreases over time; there is no evidence that smoking rates fall during gestation.