Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2016 Nov;18(11):2154-2161.
doi: 10.1093/ntr/ntw132. Epub 2016 May 17.

Time-to-Pregnancy Associated With Couples' Use of Tobacco Products

Katherine J Sapra  1 , Dana B Barr  2 , José M Maisog  3 , Rajeshwari Sundaram  1 , Germaine M Buck Louis  1
Affiliations
Observational Study

Time-to-Pregnancy Associated With Couples' Use of Tobacco Products

Katherine J Sapra et al. Nicotine Tob Res. 2016 Nov.

Abstract

Introduction: Previous studies suggest female smoking increases time-to-pregnancy (TTP), a couple-dependent reproductive outcome, while associations with male smoking are more ambiguous. Furthermore, despite small increases in smokeless tobacco use in the United States, no prior study has evaluated TTP among smokeless tobacco users.

Methods: Using population-based sampling in 16 counties in Michigan and Texas, 501 couples discontinuing contraception to become pregnant were followed until positive pregnancy test or 12 months of trying. Participants were interviewed on lifetime and current cigarette, cigar, and chew/snuff (smokeless) use and provided blood samples for quantification of heavy metals and cotinine. Fecundability odds ratios (FORs) and 95% confidence intervals (95% CIs) were estimated, adjusted for demographics/lifestyle. FORs less than 1 reflect longer TTP.

Results: Eleven percentage of females and 15% of males smoked cigarettes. Among men, 14% smoked cigars, 9% used snuff, and 2% used chew. Compared with never tobacco users, male (FOR: 0.41, 95% CI: 0.24, 0.68) and female (FOR: 0.53, 95% CI: 0.33, 0.85) smoking were individually associated with longer TTP; males' smoking remained significant (FOR: 0.46, 95% CI: 0.27, 0.79) when modeling partners together. Cadmium levels were higher in smokers than smokeless tobacco and never users; adjusting for cadmium attenuated the cigarette-TTP association, particularly among women. TTP was shorter among smokeless tobacco users relative to smokers (FOR: 2.86, 95% CI: 1.47, 5.57).

Conclusions: Compared with never users, smokeless tobacco did not alter TTP in our cohort; however, TTP was shorter compared with smokers. We observed longer TTP in male and female smokers; cadmium may partially contribute.

Implications: Both partners' preconception smoking contributed to longer TTP, highlighting the importance of both partners' lifestyles in healthy reproduction and underscores the need for couple-based preconception guidance. The male's contribution is a new finding. Higher cadmium levels may partially contribute to longer TTP in smokers, particularly among females. Though we do not observe longer TTP among a small sample of smokeless tobacco users compared with never tobacco users, we observe shorter TTP compared with smokers. Further work is needed to more thoroughly delineate the relationship between smokeless tobacco use and TTP and possible mechanisms of tobacco use's effects on reproduction.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Prevalence of tobacco use among couples in the Longitudinal Investigation of Fertility and the Environment Study (n = 501).
See this image and copyright information in PMC

References

    1. Jamal A, Homa DM, O’Connor E, et al. Current cigarette smoking among adults–United States, 2005–2014. MMWR Morb Mortal Wkly Rep. 2015;64(44):1233–1240. www.cdc.gov/mmwr/preview/mmwrhtml/mm6444a2.htm Accessed January 14, 2016. - PubMed
    1. Agaku IT, King BA, Husten CG, et al. Tobacco product use among adults—United States, 2012–2013. MMWR Morb Mortal Wkly Rep. 2014;63(25):542–547. www.ncbi.nlm.nih.gov/pubmed/24964880 Accessed September 29, 2015. - PMC - PubMed
    1. Mazurek JM, Syamlal G, King BA, Castellan RM. Smokeless tobacco use among working adults—United States, 2005 and 2010. MMWR Morb Mortal Wkly Rep. 2014;63(22):477–482. www.ncbi.nlm.nih.gov/pubmed/24898164 Accessed September 29, 2015. - PMC - PubMed
    1. Sreeramareddy CT, Pradhan PMS, Mir IA, Sin S. Smoking and smokeless tobacco use in nine South and Southeast Asian countries: prevalence estimates and social determinants from Demographic and Health surveys. Popul Health Metr. 2014;12:22. doi:10.1186/s12963-014-0022-0. - PMC - PubMed
    1. Sreeramareddy CT, Pradhan PMS, Sin S. Prevalence, distribution and social determinants of tobacco use in 30 sub-Saharan African countries. BMC Med. 2014;12(1):243. doi:10.1186/s12916-014-0243-x. - PMC - PubMed

Publication types