Introduction Pregnancy is an opportunity to promote lifestyle changes and modify the impact of earlier social and economic determinants. Our main objective was to study how decisions about smoking cessation during pregnancy evolve 4 years after delivery.
Methods In 2005–2006, puerperae were recruited in public maternities of Porto to enter a birth cohort. Within the ongoing cohort's re-evaluation at 4 years, we studied 3519 women. Marital status, educational level, income, social class and employment status were socioeconomic surrogates. Smoking before and during pregnancy was self-reported after delivery. Prevalence ratios (PR) adjusted for appropriate confounders and 95% CIs were computed using robust Poisson regression.
Results Overall, 995 (22.6%) women were smokers. During pregnancy, 10.2% did not change their consumption, 3.8% reduced and sustained the reduction 4 years after delivery, 37.3% reduced but resumed, 17.3% stopped smoking and maintained, and 31.4% ceased smoking but resumed. The probability of smoking cessation decreased with age (30–34 years: PR=0.78; 95% CI 0.62 to 0.97) and gravidity (multigesta: PR=0.72; 95% CI 0.56 to 0.92), and increased with education (≥13 years: PR=1.44; 95% CI 1.16 to 1.79) and smoking initiation age (≥18 years: PR=1.32; 95% CI 1.07 to 1.61). The sustainability of smoking cessation 4 years after delivery was associated with age (≥35 years: PR=2.19; 95% CI 1.32 to 3.61), pregnancy complications (PR=1.41; 95% CI 1.03 to 1.94) and having a new pregnancy (PR=1.14; 95% CI 1.15 to 2.33).
Conclusions Higher socioeconomic status was associated with smoking cessation during pregnancy but not with its sustainability. Although almost all women reduced or stopped smoking during pregnancy, more than half returned to their usual consumption level after delivery.
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