Predictors of Changes in Smoking From Third Trimester to 9 Months Postpartum

While much has been written about postpartum smoking relapse prevention, few have examined changes in smoking behavior from pregnancy (third trimester) through 9 months postpartum among pregnant smokers, particularly for the large number of women who decrease tobacco consumption during pregnancy but do not quit altogether.

Data were obtained from 168 women who smoked during their pregnancy. Women were followed longitudinally from their first prenatal appointment through 9 months postpartum. Maternal substance use was assessed using the Timeline Followback and verified by maternal salivary analyses. Breastfeeding, other substance use, and partner smoking were assessed through maternal interviews at each time point and were considered as potential predictors of change in smoking.

Women returned to more than half of their levels of preconception tobacco consumption by 9 months postpartum. There was one significant predictor of changes in smoking patterns pregnancy to postpartum. Women who breastfed their infants for at least 90 days smoked far less postpartum than women who breastfed for a short time or did not breastfeed at all.

As noted in previous research of pregnant quitters, postpartum relapse prevention or harm reduction interventions should ideally be timed early in the postpartum period. Additionally, promoting breastfeeding among pregnant smokers and supporting women through at least 3 months of breastfeeding may be beneficial to such interventions.