Smoking Relapse and Early Weaning Among Postpartum Women: Is There an Association?

Authors

  • Pamela A Ratner PhD, RN,

    1. Pamela Ratner is an Assistant Professor in the School of Nursing and Assistant Director, Institute of Health Promotion Research and Joy Johnson and Joan Bottorff are Associate Professors in the School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
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  • Joy L Johnson PhD, RN,

    1. Pamela Ratner is an Assistant Professor in the School of Nursing and Assistant Director, Institute of Health Promotion Research and Joy Johnson and Joan Bottorff are Associate Professors in the School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
    Search for more papers by this author
  • Joan L Bottorff PhD, RN

    1. Pamela Ratner is an Assistant Professor in the School of Nursing and Assistant Director, Institute of Health Promotion Research and Joy Johnson and Joan Bottorff are Associate Professors in the School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
    Search for more papers by this author

Address correspondence to Pamela A. Ratner, PhD, RN, School of Nursing, T201–2211 Wesbrook Mall, University of British Columbia, Vancouver, BC V6T 2B5, Canada.© 1999 Blackwell Science, Inc.

Abstract

Background: Smoking in the postpartum period may contribute to early weaning, although the nature and temporal aspect of the relationship are poorly understood. The objective of this study was to examine the association between early weaning and smoking relapse among women who stopped smoking during pregnancy. Methods: A secondary analysis of data from a randomized controlled trial was conducted. The participants were 228 women who had stopped smoking for pregnancy, who participated in a smoking relapse prevention trial, and who breastfed. Women who relapsed to daily smoking postpartum were compared with those who remained abstinent or smoked occasionally. The dependent variable was breastfeeding for less than 26 weeks (early weaning). Potential covariates included intended duration of breastfeeding, parity, partner's smoking, nicotine dependence, emotional health, return to paid employment, and various sociodemographic variables. Results: Approximately two-thirds (65.1%) of the women who relapsed to daily smoking weaned before 26 weeks compared with 33.8 percent of the women who remained abstinent or smoked occasionally. Controlling for intended duration of breastfeeding, education, and return to paid employment, women who resumed daily smoking were almost four times more likely to wean early than those who abstained or smoked occasionally. Conclusions: Early weaning may result from psychological or physiological changes associated with tobacco use. Smoking relapse prevention in the postpartum period may be one of the most effective interventions in ensuring that women who stop smoking for pregnancy remain stopped and breastfeed their babies for the recommended duration.

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