Predictors of postpartum relapse to smoking

Department of Psychology, University of Vermont, Burlington, VT 05405-0134, USA.
Drug and Alcohol Dependence (Impact Factor: 3.42). 11/2007; 90(2-3):224-7. DOI: 10.1016/j.drugalcdep.2007.03.012
Source: PubMed


Postpartum relapse is common among women who stop smoking during pregnancy. We examined predictors of postpartum relapse in 87 women who quit smoking during pregnancy, 48% of whom relapsed by 6 months postpartum. We also explored the circumstances surrounding their first postpartum cigarette. Multivariate analyses revealed that having more friends/family members who smoke, smoking more heavily pre-pregnancy, and having higher depression scores and less concern about weight at the end of pregnancy were associated with increased risk of relapse postpartum. Most women's first postpartum cigarettes were unplanned, in the presence of another smoker, and while experiencing negative affect. The findings suggest targets for interventions to reduce postpartum relapse.

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Available from: Stephen T Higgins, Oct 07, 2015
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    • "The presence of others smoking exposes smokers to smoking-related cues, which has been shown to increase craving (Carter & Tiffany, 1999) and may signal the availability of cigarettes and/or acceptability of smoking. Previous studies that used retrospective reports to identify predictors of smoking lapse revealed that half or more of all lapses occur when smokers are exposed to other people smoking (Shiffman, 1982; Solomon et al., 2007). Similarly, using ecological momentary assessment (EMA), Shiffman and colleagues (1996b) found that smokers are significantly more likely to lapse in the presence of others smoking as compared to when they are alone. "
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    ABSTRACT: Negative affect, alcohol consumption, and presence of others smoking have consistently been implicated as risk factors in smoking lapse and relapse. What is not known, however, is how these factors work together to affect smoking outcomes. This paper uses ecological momentary assessment (EMA) collected during the first 7 days of a smoking cessation attempt to test the individual and combined effects of high-risk triggers on smoking urge and lapse. Participants were 300 female smokers who enrolled in a study that tested an individually tailored smoking cessation treatment. Participants completed EMA, which recorded negative affect, alcohol consumption, presence of others smoking, smoking urge, and smoking lapse, for 7 days starting on their quit date. Alcohol consumption, presence of others smoking, and negative affect were, independently and in combination, associated with increase in smoking urge and lapse. The results also found that the relationship between presence of others smoking and lapse and the relationship between negative affect and lapse were moderated by smoking urge. The current study found significant individual effect of alcohol consumption, presence of other smoking, and negative affect on smoking urge and lapse. Combing the triggers increased smoking urge and the risk of lapse to varying degrees and the presence of all 3 triggers resulted in the highest urge and lapse risk.
    Nicotine & Tobacco Research 05/2014; 16:569-575. DOI:10.1093/ntr/ntt190 · 3.30 Impact Factor
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    • "It has been suggested that women who stop smoking during pregnancy and relapse during the postpartum period (2–6 months) are more likely to be younger (Colman & Joyce, 2003), non-White (Carmichael et al., 2000; Colman & Joyce, 2003), less educated (Colman & Joyce, 2003; Liu, Rosenberg, & Sandoval, 2006), have high parity (Colman & Joyce, 2003), have a partner who smokes (Lelong, Kaminski, Saurel-Cubizolles, & Bouvier-Colle, 2001; Letourneau et al., 2007; Ma et al., 2005; Solomon et al., 2007), be heavier smokers pre-pregnancy (Colman & Joyce, 2003; Solomon et al., 2007) and may suffer feelings of stress or depression (Allen et al., 2009; Carmichael et al., 2000; Park et al., 2009; Solomon et al., 2007); whereas, breast feeding has been suggested be a protective factor (Ratner, Johnson, & Bottorff, 1999). However, little information is available on factors associated with relapse of smoking in the early postpartum period (within the first 6 weeks). "
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    ABSTRACT: Introduction: There is increasing evidence that a high proportion (47%-63%) of women who quit smoking during pregnancy relapse during the postpartum period. The purpose of this population-based study was to examine the association between selected sociodemographic factors and smoking relapse in the early postpartum period (within the first 6 weeks) in women who had successfully quit smoking during the pregnancy. Methods: The study included 512 women resident in East Sussex, United Kingdom, who had quit smoking during the pregnancy. Information on the prevalence of smoking and selected sociodemographic factors and breast feeding at the 6-weeks postpartum review by health visitor was obtained from the Child Health Surveillance System, which records and monitors the health and development of children from birth until school entry. Results: Of the 512 women who had quit smoking during the pregnancy, 238 (46.5%) relapsed in the early postpartum period. In the bivariate analysis, there was an association between deprivation and smoking relapse in the early postpartum period (OR = 5.3, 95% CI: 2.5-11.4), with a significant trend in increasing risk of relapse with increasing level of deprivation (p < .01). Stepwise logistic regression analysis showed that women who lived in deprived urban areas (OR = 2.3, 95% CI: 1.2-4.2), had ≥3 children (OR = 3.8, 95% CI: 2.2-6.4), and had other smokers in the household (OR = 5.6, 95% CI: 3.6-8.8) were significantly more likely to relapse in the early postpartum period. On the other hand, women who were breast feeding were significantly less likely to relapse (OR = 0.6, 95% CI: 0.4-0.9). Conclusions: Factors associated with early postpartum smoking relapse identified in this study, particularly breast feeding, high parity, and concurrent smoking by partner/other household member(s), may contribute to the development of effective and targeted interventions to maintain smoking cessation in women and their household.
    Nicotine & Tobacco Research 10/2012; 15(5). DOI:10.1093/ntr/nts221 · 3.30 Impact Factor
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    • "However, compared with research in pre-quit depressive symptoms and smoking relapse, sex differences in predictive patterns of other constructs such as anxiety, anger, and perceived stress have not been fully examined in the context of long term abstinence (al'Absi, Carr, & Bongard, 2007; Patterson, Kerrin, Wileyto, & Lerman, 2008). Pomerleau, 2010; Croghan et al., 2006; Klesges, Meyers, Klesges, & LaVasque, 1989; Linares Scott, Heil, Higgins, Badger, & Bernstein, 2009; Lopez Khoury, Litvin, & Brandon, 2009; Solomon et al., 2007). However, the extent to which expectancies to relieve craving predicts prolonged abstinence in women and men has not been directly examined. "
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    ABSTRACT: The current study examined whether prequit trait negative mood and smoking motives have different predictive patterns of smoking relapse in men and women. Thirty-three female (mean age ± SEM: 34.9 ± 2.5) and 38 male (mean age ± SEM: 37.1 ± 2.3) smokers interested in smoking cessation completed forms on smoking history, negative mood (i.e., depression, anxiety, and anger), stress, and smoking motives. Participants also provided samples for measurement of cotinine and carbon monoxide. Then, they set a quit date and were required to abstain from smoking at least for 24 hours. Participants were followed up for 12 months postcessation to measure their smoking status. Cox proportional hazard models revealed that motivation to reduce craving was a unique predictor of smoking relapse in men, while depressive mood, anxiety, anger, and perceived stress were predictive of time to relapse among women. These findings remained significant after statistically controlling for smoking-related variables, providing preliminary evidence that different factors may be associated with nicotine withdrawal and smoking relapse in men and women. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
    Psychology of Addictive Behaviors 02/2012; 26(3):633-7. DOI:10.1037/a0027280 · 2.09 Impact Factor
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