Association of Intimate Partner Violence with Cigarette Smoking Before and During Pregnancy, Maryland 2004-2008 Births

Background: Smoking during pregnancy is associated with adverse pregnancy outcomes.

Objective: To determine the association of intimate partner violence (IPV) with cigarette smoking before and during pregnancy.

Methods: Data from the Pregnancy Risk Assessment Monitoring System (PRAMS) postpartum survey of a stratified random sample of 8,074 Maryland mothers, 2004-2008, were analyzed with SAS 9.2. .. IPV was defined as being “pushed, hit, kicked, slapped, choked or physically hurt” by a current or ex-partner twelve months before or during pregnancy.

Results: In Maryland, 16.5% of non-abused women reported smoking during the three months before pregnancy and 48.5% quit smoking by the last three months of pregnancy. Of the 7.4% of women who reported IPV one year before or during pregnancy, 37.4% smoked during the three months before pregnancy—more than double the prevalence of non-abused women, and 39.0% quit smoking during pregnancy. Women with the highest prevalence of IPV were black (10.5%), <25 years of age (13.3%) and received <12 years of education (11.2%). Compared with women who did not report IPV, the prevalence of smoking during the last three months of pregnancy was 2.7 times higher among women who reported IPV (22.8% vs. 8.5%), with an adjusted odds ratio of 2.4 (95% confidence interval:1.6-3.6) after adjusting for maternal race, age, and education.

Conclusion: Women who reported IPV were more likely to smoke before pregnancy and less likely to quit during pregnancy. Targeted smoking cessation programs before and during pregnancy may be of great benefit to helping these women have healthier pregnancies.