Background Partner’s smoking status is an important predictor of maternal smoking in pregnancy; however there are few UK-wide surveys which look at these effects. We investigated partnership smoking, quitting and cutting down during pregnancy in the UK’s Millennium Cohort Study.
Methods We used multinomial logistic and linear regression to investigate retrospective self-reported smoking status and reductions in cigarettes smoked of mothers and their partners. All analyses were weighted for the complex sampling design and non-response, both unadjusted and adjusted for socio-demographic status.
Results Seventy-six percent of women had respondent partners, 22% were couples who both smoked around the time of the pregnancy (unweighted N=2,954). Of these smoking couples, 37% of women quit during their pregnancy, 41% cut down, and 23% smoked the same amount (persistent smokers), respective percentages for partners were 16%, 25% and 56%. Compared to women who quit, women who cut down were more likely to have a partner who was a persistent smoker (RRR 7.6, 95% CI 4.9 to 11.7), or a cut-down smoker (5.7, 3.8 to 8.5). Compared to persistent smokers, those who cut down were slightly heavier smokers (women mean difference 1.1 cigarettes/day, partners 2.0). Women who cut down reduced average consumption to 6.3 a day (mean reduction 9.3, 95% CI 9.0 to 9.8) and partners to 10.1 (8.7, 8.1 to 9.3). There was no difference in the effect of partners’ persistent smoking on the risk of women cutting down or persistent smoking (P=0.38), but partner cutting down was a significantly larger predictor of women cutting down compared to women continuing to smoke (P=0.02). After reduction, women whose partners cut down smoked an average of 2.2 more cigarettes more than those whose partners quit (P=0.043). There was no evidence of variation in reduction for those who had partners who quit and those who were persistent smokers (d=0.87, P=0.42). Results were robust to adjustment for socio-demographics; fully adjusted results will be presented.
Conclusion Most women cut down and this was associated with partner cutdown, however this strategy was limited as partners were more likely to be persistent smokers. Significant reductions in the maternal number smoked were achieved, but the influence of partner smoking (whether persistent or cut down) may limit reduction. Cutting down as a strategy has questionable impact on in-utero exposure and may put at infants at risk for environmental tobacco smoke exposure postpartum. For maximum effect, partner and targeted couples interventions are warranted.
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