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Factors Associated with Prenatal Smoking Among Black Women in Eastern North Carolina
Authors:Email author" target="_blank">Suezanne?T?OrrEmail author  Edward?Newton  Patrick?M?Tarwater  David?Weismiller
Institution:(1) Department of Health Education and Promotion, East Carolina University, Christenbury 205, Greenville, North Carolina, USA;(2) Department of Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA;(3) School of Public Health, El Paso Regional Campus, University of Texas Health Science Center at Houston, El Paso, Texas, USA;(4) Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA;(5) Department of Health Education and Promotion, East Carolina University, Christenbury 205, Greenville North Carolina, 27858, USA
Abstract:Objectives: The objective of this research was to explore prenatal smoking behaviors among Black women attending prenatal clinics. Despite the racial disparities in poor pregnancy outcomes, and the well-known association of smoking with harmful outcomes, little research has been conducted about prenatal smoking among Black women. Methods: Women were enrolled in the study and interviewed at the time of the first prenatal visit. The interview contained items to assess prenatal smoking and cessation, depressive symptoms, demographic factors, and beliefs about smoking. Reports of smoking cessation were verified using urinary cotinine. Results: The sample consisted of 811 Black women. Fourteen percent of the women were self-reported smokers, 12.6% reported cessation and 73% were nonsmokers. Twenty percent of the self-reported quitters had elevated cotinine; when these women were reclassified, 17% of the women were smokers. Factors associated with smoking in logistic regression analysis included elevated maternal depressive symptoms (OR = 1.7, 95% CI: 1.1–2.6), maternal age 20 years or older (OR = 1.94; 95% CI: 1.1, 3.3), less than a high school education (OR = 2.2; 95% CI: 1.2, 3.8), unmarried/not living with a partner (OR = 1.9; 95% CI: 1.0, 3.6), and allowing smoking in the home (OR = 5.5; 95% CI: 3.4, 8.6). Conclusions: The prevalence of maternal prenatal smoking was much higher among women in this sample than has been previously reported. The rate of nondisclosure of smoking among self-reported quitters was also high. Maternal behavioral (allowing smoking in the home) and psychosocial factors (depressive symptoms) were associated with prenatal smoking.
Keywords:prenatal smoking  nondisclosure of smoking  depressive symptoms
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