Examining the timing of changes in cigarette smoking upon learning of pregnancy

•The time course of changes in smoking upon learning of pregnancy is unclear.•Most women reported making changes in the first 2 days after learning of pregnancy.•The rapidity of the changes suggests a behavioral or psychosocial mechanism.•These results may suggest the need for earlier intervention among smoking women.

Objective and methodTimeline Follow-back interviews were conducted with 107 pregnant women enrolling in smoking cessation and relapse prevention clinical trials in the Burlington, VT area between 2006 and 2009 to examine the time course of changes in smoking between learning of pregnancy and the first prenatal care visit. We know of no systematic studies of this topic.ResultsWomen reported learning of pregnancy at 5.1 ± 2.2 weeks gestation and attending a first prenatal care visit at 10.1 ± 3.6 weeks gestation. In the intervening five weeks, 22% of women became abstainers, 62% reduced their smoking, and 16% maintained or increased their smoking. Women who made changes typically reported doing so within the first 2 days after learning of pregnancy, with few changes occurring beyond the first week after learning of pregnancy.ConclusionIn this first effort to systematically characterize the time course of changes in smoking upon learning of pregnancy, the majority of pregnant smokers who quit or made reductions reported doing so soon after receiving the news. Further research is needed to assess the reliability of these results and to examine whether devising strategies to provide early interventions for women who continue smoking after learning of pregnancy is warranted.