Date of Award


Document Type


Degree Name

Medical Doctor (MD)

First Advisor

Eve Colson


This study prospectively examined the timing and predictors of returning to smoking after pregnancy in a group of women who quit smoking cigarettes during pregnancy. We interviewed women during the postpartum hospital stay and at their infants 2-week and 2-month health supervision visits. Urine cotinine levels were measured at each interview. Fifty-three women were interviewed during the postpartum stay, 37 women at the 2-week and 36 women at the 2 month visits. At the 2-week visit, 40.5% had returned to smoking, and at the 2-month visit, 47.2% had returned to smoking. Factors associated with a return to smoking at 2 weeks included a lower level of education (high school graduate/GED vs. some college education; 13/37 vs. 2/37, p=0.02), the presence of someone else in the household who smoked (14/37 vs. 1/37, p=0.001), formula-feeding their infant at the time of interview (14/37 vs. 1/37, p=0.003), having smoking discussed with a doctor or nurse during pregnancy (12/37 vs. 3/27, p=0.009), and being African-American vs. Caucasian or Hispanic (10/37 vs. 5/37, p=0.008). Predictors of a return to smoking at 2 months included the presence of someone else in the household who smoked (17/36 vs. 0/36, p<0.001) and smoking at least 1 cigarette during pregnancy after initially quitting (12/36 vs. 5/36, p=0.02). Women who quit smoking cigarettes during pregnancy are likely to resume in the days immediately after delivery. The presence of household smokers and formula feeding are the strongest predictors of resuming smoking within 2 weeks.


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