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Factors across the life course predict women’s change in smoking behaviour during pregnancy and in midlife: results from the National Child Development Study
  1. Danielle A J M Schoenaker1,
  2. George B Ploubidis2,
  3. Alissa Goodman2,
  4. Gita D Mishra1
  1. 1 School of Public Health, University of Queensland, Brisbane, Queensland, Australia
  2. 2 Centre for Longitudinal Studies, UCL - Instituteof Education, University College London, London, UK
  1. Correspondence to Danielle A J M Schoenaker, School of Public Health, University of Queensland, Herston, QLD 4006, Australia; danielle.schoenaker{at}


Background Tobacco smoking before, during and after pregnancy remains one of the few preventable factors associated with poor health outcomes for mothers and their children. We investigate predictors across the life course for change in smoking behaviour during pregnancy and whether this change predicts smoking status in midlife.

Methods Data were from the National Child Development Study (1958 British birth cohort). We included female cohort members who reported a first pregnancy up to age 33 years. Among 1468 women who smoked before pregnancy, we examined predictors reported in childhood (age 11 years), adolescence (age 16 years) and early adulthood (age 23 years) of change in smoking behaviour from 12 months before to during pregnancy using log-binomial regression. The association between change in smoking behaviour during pregnancy and smoking status in midlife (age 55 years) was examined while adjusting for predictors across the life course.

Results Among prepregnancy smokers (39%), 26% reduced and 35% quit smoking during pregnancy. Parental smoking and lower social class during childhood, and early adulthood lower social class, depression, early smoking initiation, high smoking intensity, living with a smoker, no pregnancy planning and early motherhood were associated with lower probability of smoking reduction or cessation in pregnancy. Compared with women who smoked before and during pregnancy, women who reduced or quit were two times more likely to be non-smoker at age 55 years (95% CI 1.76 to 2.20).

Conclusions Findings from this population-based birth cohort study lend support for smoking cessation strategies that target those at risk at various stages across the life course.

  • birth cohort study
  • epidemiology
  • life course
  • pregnancy
  • smoking cessation

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  • Contributors DAJMS contributed to conception and design of the study, performed the statistical analysis, interpreted the data and wrote the article. GBP, AG and GDM contributed to conception and design of the study, interpretation of the data and revised the article for important intellectual content. All authors have read and approved the final version of the submitted manuscript.

  • Funding DAJMS is supported by an International Postgraduate Research Scholarship and a UQ Graduate School International Travel Award, and GDM is supported by an Australian Research Council Future Fellowship (FT120100812). Funding sources had no role in study design; collection, analysis and interpretation of data; writing the article; and the decision to submit the article for publication.

  • Competing interests None declared.

  • Ethics approval Multicentre Research Ethics Committee (MREC) approval was sought for NCDS follow-ups from 2000 onwards. The 1958 and 1965 follow-ups predated the establishment of ethics committees; the 1969, 1974, 1981 and 1991 follow-ups came before the establishment of the MREC system. Internal ethical reviews were undertaken for these waves. Participants in later waves were required to sign informed consent, and ethical approval was obtained from South East and London Multicentre Research Ethics Committee. (Shepherd, P.M. An Introduction to the Background to the Study and Methods of Data Collection in The National Child Development Study. Social Statistics Research Unit, London City University 1985.) NCDS sought informed parental consent for the 7-year (1965), 11-year (1969) and 16-year (1974) surveys.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement National Child Development Study (NCDS) data are available to researchers through the UK Data Service.