| The
Lancet article in January, which purported to show that bed sharing
non-smoking mothers were at a two-fold increased risk of having a
baby die of SIDS, concerned us for many reasons. One reason was the
definition of 'non-smoking'. Mothers were defined as 'non-smoking'
if they did not smoke during pregnancy. The main author confirmed
to me that data was incomplete for smoking status around the time
of death. This means that mothers who quit during pregnancy but re-started
smoking after delivery were defined as non-smokers.
Women who delivered live births in 1996 responded to a mailed questionnaire
approximately 2 to 6 months after delivery (N =17,378). Data from
10 US states were included in the study, and the overall participation
rate was 75%. Overall, 25.6% of women reported cigarette smoking
before pregnancy. Among women who smoked before pregnancy, 44.5%
quit during pregnancy. Among women who quit during pregnancy, half
relapsed by the time of the survey.
Carmichael SL, Ahluwalia IB. Correlates of postpartum smoking relapse.
Results from the Pregnancy Risk Assessment Monitoring System (PRAMS).
Am J Prev Med. 2000 Oct;19(3):193-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&lis
t_uids=11020597&dopt=Abstract
Women are much
more likely to quit smoking around the time of pregnancy than at
any other. While the prevalence of smoking has also decreased among
pregnant women, 12% of pregnant women report current smoking. Unfortunately,
women who quit during pregnancy have extremely high rates of relapse
during the months immediately following delivery Haas JS et al.
Bupropion in breast milk: an exposure assessment for potential treatment
to prevent post-partum tobacco use. Tobacco Control 2004;13:52-56
http://tc.bmjjournals.com/cgi/content/full/13/1/52?ijkey=7394c22fca9eb4c
a640beb5719f1e12495e7a2c2#R5
An estimated
39 percent of White women who had smoked before pregnancy quit smoking
while pregnant. Of the women who quit, 70 percent resumed smoking
within one year of delivery. Of those who relapsed, 67 percent resumed
smoking within three months of delivery and 93 percent within six
months. Fingerhut LA et al. Smoking before, during, and after pregnancy.
American Journal of Public Health, Vol 80, Issue 5 541-544 http://www.ajph.org/cgi/content/abstract/80/5/541?ijkey=e43f5a3e3fc4a11a
7b3ab7ca2762296863c594a8&keytype2=tf_ipsecsha
Of women who
quit smoking beginning before the 20th week of pregnancy and continued
abstinence through delivery (n = 134), only 37 percent were still
non-smoking at 6 months postpartum. Mullen PD et al. Maintenance
of nonsmoking postpartum by women who stopped smoking during pregnancy.
American Journal of Public Health, Vol 80, Issue 8 992-994
http://www.ajph.org/cgi/content/abstract/80/8/992?ijkey=5d50132b92069b9f
a68ea0263bb9ab62c6f496a9&keytype2=tf_ipsecsha
While it has
been established that many women quit smoking during pregnancy,
little is known about postpartum maintenance of smoking cessation
and relapse. A sample of 567 women were surveyed at about 6 months
postpartum in order to (a) describe the patterns of smoking relapse;
(b) assess the perceived importance of smoking cessation in pregnancy
and postpartum; and (c) identify potentially high risk situations
for smoking relapse. Results indicate that about half (56%) of the
women who quit smoking during pregnancy relapse to smoking by 30
days postpartum. McBride CM, Pirie PL. Postpartum smoking relapse.
Addict Behav. 1990;15(2):165-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&lis
t_uids=2343790&dopt=Abstract
A substantial
proportion of women who quit smoking during pregnancy will relapse
in postpartum. 106 women who quit smoking during pregnancy were
surveyed by telephone after the 28th week of pregnancy, and at 6
weeks and 6 months postpartum. Point prevalence estimates of smoking
relapse indicated that at 6 weeks and 6 months follow-up, 24% (n
= 26) and 40% (n = 42), respectively, of the women had returned
to regular smoking. McBride CM, Pirie PL, Curry SJ. Postpartum relapse
to smoking: a prospective study. Health Educ Res. 1992 Sep;7(3):381-90.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&lis
t_uids=10148743&dopt=Abstract
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