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November 2002, Vol 92, No. 11 | American Journal of Public Health 1801-1808
© 2002 American Public Health Association

RESEARCH AND PRACTICE

A Reexamination of Smoking Before, During, and After Pregnancy

Robert S. Kahn, MD, MPH, Laura Certain, BA and Robert C. Whitaker, MD, MPH

Robert S. Kahn and Robert C. Whitaker are with the Division of General and Community Pediatrics, Children’s Hospital Medical Center, Cincinnati, Ohio. Laura Certain is with the University of Washington School of Medicine, Seattle, Wash.

Correspondence: Requests for reprints should be sent to Robert S. Kahn, MD, MPH, Division of General and Community Pediatrics, Children’s Hospital Medical Center, TCHRF 6549, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (e-mail: robert.kahn{at}chmcc.org).

Objectives. This study examined the patterns and correlates of maternal smoking before, during, and after pregnancy.

Methods. We examined socioeconomic, demographic, and clinical risk factors associated with maternal smoking in a nationally representative cohort of women (n = 8285) who were surveyed 17 ± 5 months and again 35 ± 5 months after delivery.

Results. Smoking rates among women with a college degree decreased 30% from before pregnancy to 35 months postpartum but did not change among the least educated women. Risk factors clustered, and a gradient linked the number of risk factors (0, 2, 4) to the percentage smoking (6%, 31%, 58%, P < .0001).

Conclusions. The period of pregnancy and early parenthood is associated with worsening education-related disparities in smoking as well as substantial clustering of risk factors. These observations could influence the targeting and design of maternal smoking interventions.




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