Socio-demographic and motivational correlates of smoking status at term and postpartum

Abstract

Background: Tobacco consumption during pregnancy has consequences for pregnant women and their fetus, as well as during the postnatal period. Many women stop their tobacco consumption during pregnancy, but statistics vary about the exact proportion, and a non-negligible number of them are still smoking at term. Moreover, tobacco relapse after birth is frequent. This study aims to provide epidemiological indicators about tobacco consumption at term and post-partum relapse in Switzerland, and test risks factors associated with tobacco consumption at term, including Theory of Planned Behaviour variables for the motivational correlates. Losses to follow-up precluded testing risk factors associated with post-partum relapse.

Participants and procedure: Respondents were recruited at the pre-birth consultations at the hospital and answered the initial survey. They were contacted by email in the post-partum period two and six months after childbirth.

Results: 10.6% of our sample were still smoking at the end of their pregnancy. The low-end estimate of relapse is 21.2% at two months (the high-end estimate being 74% after six months, using the worst-case scenario). Higher education level, income, and multiparity were descriptively associated with less tobacco consumption at term. Perceived behavioural control was the motivational variable differing the most between smokers and non-smokers, and with the broadest variance. Scores of attitudes and subjective norms had higher levels and were more consensual.

Conclusions: Incidence of tobacco consumption during pregnancy and during the post-partum period is problematic in Switzerland. One promising avenue is increasing pregnant women's perceived behavioural control toward smoking cessation during pregnancy and long-term abstinence.

Keywords: perceived behavioural control; pregnancy; self-efficacy; smoking relapse; theory of planned behaviour.

Figure 1

Flowchart of participants

Figure 2

Confidence interval-based estimation of relevance plot for the TPB predictors (attitude, subjective norm, perceived behavioural control) on intention to remain abstinent after childbirth

Figure 3

Confidence interval-based estimation of relevance plot for the TPB predictors (attitude, subjective norm, perceived behavioural control, intention to remain abstinent after childbirth) associated with the current smoking status