Breastfeeding duration is positively associated with decreased smoking relapse in the postpartum period

A significant proportion of women quit smoking during pregnancy, creating a unique window of opportunity to encourage long-term smoking cessation. Efforts to prevent smoking relapse in the postpartum period, however, have largely been ineffective. We investigated the association between breastfeeding duration and smoking relapse to help inform postpartum smoking cessation strategies.

The Ulm SPATZ Health Study consists of 1006 newborns and their 970 mothers recruited from April 2012 to May 2013 in Ulm, Germany. For this analysis, only mothers who quit smoking during pregnancy, for whom breastfeeding and smoking data were available, were included. Kaplan-Meier plots were used to investigate the relationship between breastfeeding duration and postpartum smoking relapse within 2 years. Cox proportional hazards regression models were used to estimate hazard ratios, adjusted for factors reported to influence postpartum smoking outcomes.

A total of 115 mothers were included. They had a mean age of 32.0 (SD: 5.0) years and breastfed for 5.6 (SD: 4.4) months. Of those who remained in the study, 14 (12.2%) experienced smoking relapse by 6 weeks and 48 (51.1%) relapsed by 2 years. In an adjusted analysis which accounted for age, educational attainment, postpartum weight retention, and gestational weight gain, breastfeeding for at least 6 months was significantly associated with decreased smoking relapse within 2 years (HR: 0.18; 95% CI: 0.07 - 0.45).

Breastfeeding for at least 6 months was associated with decreased postpartum smoking relapse. Breastfeeding promotion should be considered to enhance smoking cessation strategies in the postpartum period.