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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    • "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.
    Full-text · Article · May 2014 · Nicotine & Tobacco Research
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    • "After giving birth, however, many Japanese mothers who quit, resumed smoking (Yasukouchi et al. 2006, Yasuda et al. 2013 28 ), although not quite as quickly as in those in Western Europe or in U.S. (e.g. Colman et al., 2003; Lelong et al., 2001; Polanska et al., 2011; Solomon et al., 2007. Of course, infants and small children are vulnerable to secondhand smoke, too. "
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    ABSTRACT: The exposure of children to secondhand smoke at home and elsewhere has been a largely overlooked problem in Japan, regardless of well spread knowledge about the health risks of secondhand smoke exposure to children. Furthermore, evidence and studies are limited and little is known about the relationship between smoking behavior and socioeconomic factors in Japan. In this research, our broad perspective is to identify the important risk factors of women's smoking. We first focus on the mother, who has the greatest impact on her children's health. Thus, our main interest here is to demonstrate the mothers' behavior during the first year after the birth of a child. We also address the association between women's smoking behavior from several different points of view including their characteristic, family or social environments. Using various years of the Comprehensive Survey of Living Conditions, and multivariate logistic regressions, we show that mothers cessation of smoking after delivery is unstable in Japan, depending on the age and the parity of a child. For a first child, more than two-thirds of women who used to smoke abstain from smoking at least for one year. For a second child, compared with a first child, only half of the mothers quit temporarily in the 
    Full-text · Chapter · Jan 2014
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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.
    Full-text · Article · Oct 2012 · Nicotine & Tobacco Research
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