IMPACT of socioeconomic factors on tobacco smoking cessation during pregnancy

Background: Although pregnancy is an optimal time for spontaneous tobacco cessation, many women continue to smoke. Identifying the population at greatest risk for continued smoking is essential for early and effective interventions.

Methods: Using the obstetrical records of all birth outcomes in 2009 and 2011 and self-administered questionnaires, we collected demographic and socioeconomic data of mothers living in Hungary's northeastern regions. The sample (n=12,396) represents 75.35% of the total target population. We assessed socioeconomic factors that increase the likelihood of continued smoking during pregnancy using SPSS 20.0 and binary logistic regression modeling (OR and 95%CI. ).

Results: 41% (n=5,033) of the whole sample was regularly smoking when they learned they were pregnant. Among them 36.7% (n=1847) quit instantly. Compared to mothers who smoked during pregnancy, quitters initiated smoking later (16.5 vs.15.0 years) and became regular smokers later in life(18.07 vs. 16.04 years). Continuing smoking during the pregnancy was associated with Roma ethnicity (OR:3.8; (95%CI:2.9-4.96), low education (≤ 8 completed basic school classes) (OR:2.28; 95%CI:1.8-2.91), living with a smoking husband/partner (OR:1.93; 95%CI:1.55-2.42), unemployment (OR:1.76; 95%CI: 1.39-2.23), and living in deep poverty (OR:1.44; 95%CI:1.1-1.9).

Conclusion: While among people who quit spontaneously the main aim of intervention is to maintain a long-range/definitive cessation by preventing any relapse, among women who were regular smoker prior the pregnancy eliminating second hand smoking needs to be added to the program based on complex methods adjusted to the specific socioeconomic circumstances.