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Smoking and quit attempts during pregnancy and postpartum: a longitudinal UK cohort

Cooper, Sue; Orton, Sophie; Leonardi-Bee, Jo; Brotherton, Emma; Vanderbloemen, Laura; Bowker, Katharine; Naughton, Felix; Ussher, Michael; Pickett, Kate E.; Sutton, Stephen; Coleman, Tim


Professor of Medical Statistics and Epidemiology

Emma Brotherton

Laura Vanderbloemen

Felix Naughton

Michael Ussher

Kate E. Pickett

Stephen Sutton

Professor of Primary Care


Objectives Pregnancy motivates women to try stopping smoking, but little is known about timing of their quit attempts and how quitting intentions change during pregnancy and postpartum. Using longitudinal data, this study aimed to document women’s smoking and quitting behaviour throughout pregnancy and after delivery.

Design Longitudinal cohort survey with questionnaires at baseline (8–26 weeks’ gestation), late pregnancy (34–36 weeks) and 3 months after delivery.

Setting Two maternity hospitals in one National Health Service hospital trust, Nottingham, England.

Participants 850 pregnant women, aged 16 years or over, who were current smokers or had smoked in the 3 months before pregnancy, were recruited between August 2011 and August 2012.

Outcome measures Self-reported smoking behaviour, quit attempts and quitting intentions.

Results Smoking rates, adjusting for non-response at follow-up, were 57.4% (95% CI 54.1 to 60.7) at baseline, 59.1% (95% CI 54.9 to 63.4) in late pregnancy and 67.1% (95% CI 62.7 to 71.5) 3 months postpartum. At baseline, 272 of 488 current smokers had tried to quit since becoming pregnant (55.7%, 95% CI 51.3 to 60.1); 51.3% (95% CI 44.7 to 58.0) tried quitting between baseline and late pregnancy and 27.4% (95% CI 21.7 to 33.2) after childbirth. The percentage who intended to quit within the next month fell as pregnancy progressed, from 40.4% (95% CI 36.1 to 44.8) at baseline to 29.7% (95% CI 23.8 to 35.6) in late pregnancy and 14.2% (95% CI 10.0 to 18.3) postpartum. Postpartum relapse was lower among women who quit in the 3 months before pregnancy (17.8%, 95% CI 6.1 to 29.4) than those who stopped between baseline and late pregnancy (42.9%, 95% CI 24.6 to 61.3).

Conclusions Many pregnant smokers make quit attempts throughout pregnancy and postpartum, but intention to quit decreases over time; there is no evidence that smoking rates fall during gestation.


Cooper, S., Orton, S., Leonardi-Bee, J., Brotherton, E., Vanderbloemen, L., Bowker, K., …Coleman, T. (2017). Smoking and quit attempts during pregnancy and postpartum: a longitudinal UK cohort. BMJ Open, 7(11), Article e018746.

Journal Article Type Article
Acceptance Date Sep 28, 2017
Online Publication Date Nov 15, 2017
Publication Date Nov 1, 2017
Deposit Date Oct 20, 2017
Publicly Available Date Nov 1, 2017
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 7
Issue 11
Article Number e018746
Keywords Smoking cessation; Pregnancy; Longitudinal research; Quit attempts; Postpartum relapse; Survey research
Public URL
Publisher URL


Cooper BMJ Open 2017 e018746.pdf (746 Kb)

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