Social Integration and Maternal Smoking: A Longitudinal Analysis of a National Birth Cohort

Abstract

Objectives Social support and engagement are related to smoking behavior in general populations, but it is unknown whether these measures of social integration as experienced by recent mothers are related to longitudinal maternal smoking patterns. The purpose of this study is, first, to describe longitudinal patterns of maternal smoking before, during, and after pregnancy through the early childhood parenting years, as well as variation in these patterns; and second, to examine these patterns in relation to social integration, emotional, behavioral, and sociodemographic factors. Methods Among 9,050 mothers of the Early Childhood Longitudinal Study-Birth Cohort (a nationally representative probability sample of children born in 2001), we estimated trajectories of maternal smoking with general growth mixture model (GGMM), and examined how baseline predictors are associated with these patterns over a 5 to 6 year period beginning three months prior to pregnancy. Results A 5-class solution identified trajectories of nonsmokers (70.5%), temporary quitters (9.4%), pregnancy-inspired quitters (3.3%), delayed initiators (5.1%), and persistent smokers (11.7%). Modifiable risk factors included postpartum alcohol consumption and behavioral cues from co-resident smokers, while breastfeeding beyond six months and social engagement through religious service attendance were protective characteristics. Conclusions Prevention of and treatment for maternal perinatal and postpartum smoking is best informed by mothers’ emotional, behavioral and sociodemographic characteristics. Religious service attendance, but not measures of social support or social engagement, is a protective factor for maternal smoking trajectories.

Trajectories of pre- and postnatal co-use of cannabis and tobacco predict co-use and drug use disorders in adult offspring

“…The goals of this study are to (1) identify and describe trajectories of any maternal co-use of tobacco cigarettes and cannabis, and (2) to determine if specific trajectories of any maternal co-use during gestation and postpartum periods are associated with adult offspring risk for co-use and drug use disorders. Based on the extant literature on trajectories of prenatal and postnatal maternal use of single substances (De Genna et al, 2015a; 2015b, 2016b, 2017b; Liu et al, 2016; Liu & Mumford, 2017; Mumford & Liu, 2016; Tran et al, 2015a; 2015b; Tucker et al, 2006), we hypothesized that there would be distinct trajectories of maternal co-use of tobacco cigarettes and cannabis across the prenatal and postpartum periods, with different patterns of pre- and postpartum desistance. As maternal substance use is known to predict substance use in offspring, we hypothesized that the adult offspring of chronic co-users would be more likely to be co-users themselves, and more likely to develop a drug use disorder by age 22.…”

Quitting Smoking before and after Pregnancy: Study Methods and Baseline Data from a Prospective Cohort Study

“…These results were similar to those from Orton et al that found women who smoke during pregnancy are more likely to hold no educational qualifications, were less likely to own a home, and more likely to engage in unpaid work [ 23 ]. Socioeconomic disparities are even more prominent when smokers or recent quitters are compared with nonsmokers [ 11 , 14 ].…”

“…Despite these problems, in the United States (US), one in fourteen women smoke during pregnancy [ 10 ]. Some women quit tobacco use when they learn about their pregnancy, but most return to smoking following birth [ 11 , 12 , 13 , 14 ].…”

“…Cross-sectional and longitudinal studies have identified important variables related to tobacco use and relapse both during pregnancy and postpartum such as socioeconomic status, depression, and having a partner who smokes [ 11 , 12 , 14 , 15 , 16 ]. In the United Kingdom (UK), Munafò and investigators found that a reduction in depressive symptoms during the course of pregnancy to the immediate postnatal period was associated with smoking cessation [ 15 ].…”

“…In the UK, almost 40% of women reported no discussion of quitting with a health care provider across the entire pregnancy despite the fact that approximately half of the women were interested in receiving support to stop smoking [ 22 ]. Many of these prior studies have relied on retrospectively reported tobacco use data for preconception and pregnancy [ 11 , 12 ] or did not assess concurrent changes in psychosocial variables related to tobacco use that can be informative for intervention development [ 11 , 12 , 14 , 17 , 18 , 22 , 23 ]. Importantly, no studies have prospectively examined associations between women’s perceptions of the quality of smoking cessation treatment during pregnancy and postpartum and any resultant changes in smoking status.…”