Correlates of postpartum smoking relapse: Results from the pregnancy risk assessment monitoring system (PRAMS) Review Article

Background: Using population-based data from the Pregnancy Risk Assessment Monitoring System (PRAMS), this study examines the prevalence and intensity of smoking before, during, and after pregnancy, and identifies correlates of postpartum smoking relapse. Methods: Women who delivered live births in 1996 responded to a mailed questionnaire approximately 2 to 6 months after delivery (N =17,378). Data from 10 states participating in PRAMS were included in the study, and the overall participation rate was 75%. Analyses were adjusted for survey design and sampling strategy. Logistic regression analysis identified independent correlates of smoking relapse. Results: Overall, 25.6% of women reported cigarette smoking before pregnancy. Among women who smoked before pregnancy, 44.5% quit during pregnancy. Among women who quit during pregnancy, half relapsed by the time of the survey. Independent correlates associated with increased risk of postpartum relapse included African American race/ethnicity, multiparity, high maternal weight gain, late or no prenatal care, and stressful life events. Conclusions: Correlates of postpartum smoking relapse identified by this study may contribute to the development of effective and targeted interventions to maintain long-term smoking cessation.