Postpartum Smoking Relapse Linked To Weight Worries
Two-thirds of women who quit smoking during pregnancy want to avoid cigarettes after delivery, but concern about weight may interfere, according to a new study.
“A woman's feeling about her ability to control her weight affected her motivation to smoke,” said lead author Michele Levine, Ph.D., at the University of Pittsburgh Medical Center. This association went “above and beyond” factors including a woman's level of dependence on nicotine, whether she had a partner who smoked and whether she planned to breastfeed her baby.
Levine and her colleagues conducted the study to understand why so many women resume prior smoking habits after pregnancy. Levine said that although there's a lot of research on helping women to quit during pregnancy, “something happens after the baby is born that leads women to go back to smoking.”
The authors interviewed 119 pregnant women who smoked at least eight cigarettes a day before pregnancy but quit once they became pregnant. During the third trimester, the women responded to the question, "How motivated do you feel to stay quit after your baby is born?" Based on their responses, researchers divided the women into two groups: those highly motivated and those less motivated to remain smoke-free after birth.
The women were also asked if they felt confident about their ability to avoid cigarettes after giving birth and if they thought they could manage their weight after quitting smoking.
Study questions also addressed symptoms of stress and depression, since mood may affect a woman's desire to abstain from smoking.
Sixty-five percent of women in the study - published in the October issue of the Annals of Behavioral Medicine - reported feeling highly motivated to steer clear of cigarettes after delivery and 74 percent expressed confidence in their ability to do so, a finding supported by previous research. Not surprisingly, the authors said, women who felt highly motivated to avoid smoking also tended to feel confident that they could do so.
What surprised the authors was the link between weight concerns and desire to remain abstinent. Compared to less-motivated women, “Motivated women were more likely to say they could control their weight without smoking and less likely to say they used smoking to control their weight,” Levine said. Women motivated to remain smoke-free during the postpartum period were also more likely to say they would breastfeed their infants.
Elyse Park, Ph.D., a psychologist in Boston not involved with the study, said the results deal only with what women intend to do after delivery - not their actual behavior. "Most women who are smoking want to quit during pregnancy, but the reality is that very few of them are able to do so. Even in women who are successful, very few are able to maintain quitting," she said.
Because weight concerns are such a prevalent problem for American women, finding ways to address concerns about eating and weight may help prevent postpartum smoking relapse, the authors suggested.
Park suggests that pregnant women who want to remain smoke-free find a behavioral program - whether that's quitting cold turkey or taking a stepwise approach to cutting back on cigarettes - that fits them. “There's a lot of stigma against smoking during pregnancy; a lot of women genuinely want to quit but they're struggling to do so,” she said.
This research was supported by a grant from the National Institute on Drug Abuse.
Annals of Behavioral Medicine is the official peer-reviewed publication of The Society of Behavioral Medicine. For information about the journal, contact Alan J. Christensen, Ph.D., at (319) 335-3396. Visit the Society of Behavioral Medicine at