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Preconception and Prenatal Smoking among Maine Women: Defining Risk and Determining the Impact of Efforts by Care Providers to Promote Cessation

Published online by Cambridge University Press:  28 June 2017

David E. Harris*
Affiliation:
School of Nursing, University of Southern Maine, Portland, Maine
AbouEl-Makarim A. Aboueissa
Affiliation:
Department of Mathematics and Statistics, University of Southern Maine, Portland, Maine
Cheryl Sarton
Affiliation:
School of Nursing, University of Southern Maine, Portland, Maine
Nancy Baugh
Affiliation:
College of Graduate & Professional Studies, Franklin Pierce University, Rindge, New Hampshire
*
Address for correspondence: David E. Harris, School of Nursing, University of Southern Maine, Portland, ME 04104. Email: [email protected]

Abstract

Introduction: Smoking before and during pregnancy is a risk for women and their babies, but encouraging tobacco abstinence challenges practitioners.

Aims: We define correlates of tobacco use around pregnancy and determine the impact of providers’ efforts to encourage abstinence.

Methods: We analysed responses (2000 – 2010) from the Pregnancy Risk Assessment Monitoring System questionnaire for Maine, United States, a state with higher than average smoking rates. We performed multivariable logistic regression analysis with demographic and behavioural independent variables, and smoking in the last 3 months before and in the last 3 months of pregnancy as dependent variables.

Results: Of 12,409 questionnaire responders, 32% smoked before pregnancy; 60.5% of these women continued during pregnancy. Women were more likely to smoke before pregnancy and to continue during pregnancy if they had a previous birth, were unmarried, had ≤ a high school education, or had a household income ≤ $20,000/year. Pre-pregnancy smokers were more likely to continue smoking during pregnancy if their gestational weight gain was less than recommended and, surprisingly, if they recalled a provider discussion about smoking cessation.

Conclusions: We identify women at risk for smoking before and during pregnancy and demonstrate that current tobacco abstinence interventions by providers may not always be effective.

Type
Protocol
Copyright
Copyright © The Author(s) 2017 

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