3.1. Differences between women who relapsed and remained abstinent postpartum
By 6 months postpartum, 42 of the 87 women (48%) who had stopped smoking during pregnancy had relapsed. presents the demographic, smoking history, and psychosocial variables for those who remained abstinent and those who had relapsed. Because 98% of the participants were non-Hispanic Caucasians, race/ethnicity is not presented in the table. Women who relapsed were younger (p = .04), less likely to be married (p = .05), less likely to have private insurance (p = .02), smoked more cigarettes per day pre-pregnancy (p = .001), were less likely to have already quit when they came in for their first prenatal visit (p = .02), and had more friends and family who smoked (p = .004). Additionally, women who relapsed scored higher than abstinent women on the Beck Depression Inventory (p = .02) and on a stress rating (p = .02) at the end of pregnancy.
Predictors of 6-Month Postpartum Smoking Status in Women Abstinent at End of Pregnancy.
To better understand the association between participant characteristics and risk of relapse, stepwise logistic regression was used to determine the best set of predictors while accounting for the correlation among potential explanatory variables. The derived model predicted relapse significantly better than the intercept-only model (X2 = 29.7, df = 5, p <.001). Increased risk of relapse was associated with smoking more cigarettes per day pre-pregnancy [OR = 1.66 per 5 cigarette increase, 95% CI: 1.14, 2.43, p = .009], higher scores on the Beck Depression Inventory at the end of pregnancy [OR = 1.21; 95% CI: 1.06, 1.38, p = .004], and having more friends and family members who smoke [OR = 3.24 (some/most vs. none/few), 95% CI: 1.13, 9.27, p = .03]. Greater concern about one’s weight was associated with decreased odds of relapse [OR = 0.76 per unit increase on 0-10 point scale; 95% CI: 0.62, 0.93, p = .008]. Treatment condition was not a significant predictor of relapse [OR = 1.51 for non-contingent versus contingent; 95% CI: 0.50, 4.62, p = .47].
3.2. Circumstances of first postpartum cigarette
Of the 42 women who relapsed, 36 (86%) completed a questionnaire assessing the circumstances of their first postpartum cigarette. Of the six missing data, three were missing in error and three could not remember their first post-delivery cigarette circumstance.
Of those who relapsed, 31% relapsed within the first 30 days after delivery; 39% relapsed between one and three months; 30% relapsed between three and six months after delivery. Eighty-six percent reported they had not planned to return to smoking, and 45% were still breastfeeding when they smoked their first postpartum cigarette. Nearly half (47%) had their first cigarette in the evening; 37% smoked in the afternoon; 16% smoked in the morning. Results revealed that 64% of the women were around someone else who was smoking at the time of their first cigarette. Their mean fatigue rating on a 0-10 point scale was 5.3 (SD = 3.7). At the time of first cigarette, 67% were experiencing a high energy, negative emotion (e.g., stressed, anxious, angry, frustrated); 17% were feeling a high energy, positive emotion (e.g., happy, upbeat, cheerful, energetic); 9%, a low energy, negative emotion (e.g., sad, lonely, bored, depressed); and 6%, a low energy, positive emotion (e.g., calm, peaceful, contented, relaxed). Twenty-three percent of the women were consuming alcohol when they relapsed; 13% were drinking a caffeinated beverage.