The relationship between pregnancy intention and change in perinatal cigarette smoking: An analysis of PRAMS data

This study examined the relationship between pregnancy intention and change in perinatal cigarette smoking from a large national sample of women in the United States, the 2004–2008 Pregnancy Risk Assessment Monitoring System (PRAMS). The study sample consisted of 49,510 female smokers. Smoking rates and quantities were captured prior to pregnancy, the last 3 months of pregnancy, and postpartum. Changes in smoking were compared between pregnancies classified as intended, mistimed, and unwanted. Regardless of pregnancy intention status, most behavior change happened before the final 3 months of pregnancy. Overall, most women were able to quit or reduce smoking. However women with unwanted pregnancies had 0.86 times the adjusted odds of quitting/reducing cigarette smoking compared to women with intended or mistimed pregnancies (95% CI: 0.78, 0.95). Findings suggest early smoking cessation interventions lead to greater change in smoking, regardless of pregnancy intention, although change is more difficult for women with unwanted pregnancies.