Strategies to Avoid Returning to Smoking (STARTS): A randomized controlled trial of postpartum smoking relapse prevention interventions

Levine, Michele D.; Marcus, Marsha D.; Kalarchian, Melissa A.; Cheng, Yu

doi:10.1016/j.cct.2013.10.002

Cited by 19 publications

(19 citation statements)

References 76 publications

(89 reference statements)

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“…First, women were recruited for a larger trial designed to prevent postpartum smoking relapse [34] and thus the generalizability of the sample is limited and direct comparison to rates of excessive GWG or psychiatric disorders among women who had not quit smoking is not possible. Second, psychiatric disorders were assessed with an interview designed using DSM-IV criteria, and DSM-5 criteria are now available.…”

Section: Discussionmentioning

confidence: 99%

“…Eligibility for the larger study, which has been detailed elsewhere, [34] required women to have stopped smoking during or immediately prior to this pregnancy. Participants for this study were 281 pregnant former smokers who completed the Structured Clinical Interview for DSM-IV-TR Axis I Disorders: Non-Patient Version (SCID-I/NP) and had GWG data available.…”

Section: Methodsmentioning

confidence: 99%

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Psychiatric disorders and gestational weight gain among women who quit smoking during pregnancy

Levine

Cheng

Marcus

et al. 2015

Journal of Psychosomatic Research

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Objective Pregnancy is a common time for women to quit using cigarettes and other substances. Such changes in substance use as well as other psychiatric and psychosocial changes during pregnancy can affect gestational weight gain (GWG). Thus, we evaluated the relationship between psychiatric disorders and GWG among pregnant women who had quit smoking. Methods Pregnant former smokers (n = 281) enrolled in a larger trial for postpartum relapse prevention completed semi-structured psychiatric interviews and measures of prepregnancy nicotine dependence and smoking behavior, and were weighed to estimate gestational weight gain. Using linear regression and mixed-effect models, the relationship between a lifetime prevalence of each psychiatric disorder and total GWG was evaluated, controlling for variables previously related to GWG. Results Average GWG was 15.6 (± 8.5) kg, and 56% (n = 157) of women exceeded the GWG recommended by the Institute of Medicine (IOM) according to prepregnancy BMI. Over one-third (34.3%) of pregnant former smokers had a history of at least one diagnosable psychiatric disorder. History of psychiatric disorder was unrelated to GWG, with one exception; lifetime history of alcohol use disorder was associated with significantly larger GWG. Conclusion Women who quit smoking during pregnancy gain a considerable amount of gestational weight, and a previous history of alcohol use disorder is related to GWG. However, the benefits of smoking cessation to maternal and fetal health likely outweigh the disadvantage of weight gain, and other psychiatric disorders are not linked to GWG.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Psychiatric disorders and gestational weight gain among women who quit smoking during pregnancy

Levine

Cheng

Marcus

et al. 2015

Journal of Psychosomatic Research

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“…Participants were part of a larger randomized controlled trial investigating the efficacy of a postpartum tobacco relapse prevention intervention that included a specialized focus on women’s postpartum concerns about mood and weight (Levine et al, 2013). Participants were pregnant women who self-reported smoking cigarettes daily for at least 1 month during the 3 months prior to pregnancy, smoked at least 5 cigarettes per day before quitting, had not smoked cigarettes during the past 2 weeks, and were motivated to remain abstinent postpartum.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers

Emery

Gregory

Grace

et al. 2016

Addictive Behaviors

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Background Following tobacco and alcohol, cannabis is the most commonly used substance during pregnancy. Given the high prevalence of concurrent cannabis and tobacco use as well as the health consequences associated with prenatal substance use, we sought to document the relative contributions of psychosocial and psychiatric factors commonly associated with cannabis use in predicting a lifetime cannabis use disorder (CUD) among women who had quit smoking tobacco as a result of pregnancy. Methods Pregnant former tobacco smokers (n = 273) enrolled in a larger randomized controlled trial for postpartum tobacco relapse prevention completed semi-structured psychiatric interviews and self-reported demographic, pregnancy, health, psychosocial, and tobacco use factors during their third trimester of pregnancy. Results In total, 14% (n = 38) of women met criteria for a lifetime CUD. The strongest predictors of a lifetime CUD were a history of having multiple psychiatric disorders (OR = 36.44; 95% CI = 5.03–264.27; p < 0.001) followed by a lifetime alcohol use disorder (OR = 3.54; 95% CI = 1.27–9.87; p < 0.05). In addition, more frequent attempts to quit smoking tobacco (OR = 1.12; 95% CI = 1.01–1.25; p < 0.05) and lower self-efficacy about weight management after quitting smoking tobacco (OR = 0.78; 95% CI = 0.62–0.97; p < 0.05) also were significantly associated with a lifetime CUD. Conclusions Women with a history of both cannabis and tobacco dependence may represent a subset of women who need more specialized treatment during the perinatal period to improve substance use outcomes.

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“…In both studies, participants were initially assessed in the third trimester (i.e., at least 28 weeks gestation). The combined group of women included in the present study were participating in either an ongoing randomized controlled trial designed to examine the efficacy of two approaches to prevent postpartum smoking relapse (n = 141; Levine, Cheng, Marcus & Kalarchian, 2013) or a naturalistic study aimed at identifying predictors of postpartum relapse (n = 112; Levine, Marcus, Kalarchian, Houck, & Cheng, 2010). …”

Section: Methodsmentioning

confidence: 99%

Association of Restraint and Disinhibition to Gestational Weight Gain among Pregnant Former Smokers

Slane

Levine

2015

Women's Health Issues

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Gaining excessive weight during pregnancy is associated with immediate maternal and fetal complications as well as longer term obesity. Pre-pregnancy body mass index, age, and smoking cessation have been related to gestational weight gain (GWG); however, less is known about how eating behaviors, that may be amenable to modification and have been related to weight gain outside of pregnancy, affect GWG. The present study evaluated the relationship of dietary restraint and disinhibition to GWG in a sample of women (n=248) who quit smoking before or early in pregnancy. Women self-reported height and pre-pregnancy weight during their third trimester. GWG was calculated by subtracting pre-pregnancy weight from third-trimester weight. The Three-Factor Eating Questionnaire assessed restraint and disinhibition. Average GWG was 14.60 (+7.64) kg and 47% of women had a GWG above the Institute of Medicine recommendations. Linear regression models were used to examine restraint and disinhibition as correlates of GWG, and multinomial logistic regressions were utilized to determine whether eating behaviors were associated with inadequate or excessive GWG. Restraint was positively associated with total GWG but disinhibition was not associated with GWG. Thus, conscious attempts to restrict intake were associated with GWG beyond the influence of covariates. These findings highlight the potential influence of modifiable eating behaviors on GWG and demonstrate the need for additional research to determine how these behaviors relate to GWG over the course of pregnancy.

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Strategies to Avoid Returning to Smoking (STARTS): A randomized controlled trial of postpartum smoking relapse prevention interventions

Cited by 19 publications

References 76 publications

Psychiatric disorders and gestational weight gain among women who quit smoking during pregnancy

Psychiatric disorders and gestational weight gain among women who quit smoking during pregnancy

Prevalence and correlates of a lifetime cannabis use disorder among pregnant former tobacco smokers

Association of Restraint and Disinhibition to Gestational Weight Gain among Pregnant Former Smokers

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