Although many women quit smoking during pregnancy to protect their unborn children from the effects of cigarettes, half of them resume the habit within a few months of giving birth.

According to the study at the University of North Carolina at Chapel Hillt, women with a live-in partner who shared some of the burden of child-rearing were more likely to remain smoke free, while women who were single mothers or who lacked the social and financial resources to deal with being a new parent were more likely to relapse.

Smoking during pregnancy increases the risks of pregnancy complications, decreased birth weight and SIDS (Sudden Infant Death Syndrome), said Carol E. Ripley-Moffitt, MDiv, research associate in UNC’s department of family medicine and the study’s lead author.

She noted that the past 15 years have seen a steady decrease in the number of women who smoke while pregnant, in part because of an overall decline in smoking rates among all women of childbearing age and in part because of interventions targeting women during the prenatal period.

“But more needs to be done because over 50 percent of women who quit the habit during pregnancy are smoking again at six months postpartum,” Ripley-Moffitt said.

 

Ripley-Moffitt and colleagues interviewed pregnant women attending prenatal clinics in central North Carolina who had quit smoking before 30 weeks gestation. Of the 94 women enrolled in the study, 43 had remained smoke-free and 51 had relapsed when interviewed at 4 months postpartum.

Researchers asked all women about their decision to quit during pregnancy, how they quit, and what they would do in the future.

Women who had remained smoke-free were asked about the benefits they had experienced, how they would handle temptations to smoke, how they had rewarded themselves for not smoking, and what support they might need to remain smoke-free.

Women who had relapsed were asked to describe specific situations that caused them to return to smoking, their feelings about smoking again, perceptions about the dangers of secondhand smoke, and what would need to be different in their lives in order to stop smoking again.

Several factors emerged to differentiate the two groups of women. Those who remained smoke-free postpartum were bolstered by strong social support, strong internal belief systems, strong beliefs in postpartum health benefits of not smoking, negative experiences with a return to smoking and concrete strategies for dealing with temptations.

Women who relapsed postpartum were undermined by easy access to cigarettes, reliance on cigarettes to deal with stress, lack of financial resources, lack of resources for childrearing and low self-esteem. 

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