Smoking Behavior of Women Before, During, and after Pregnancy: Indicators of Smoking, Quitting, and Relapse

<b><i>Background:</i></b> Smoking cessation during pregnancy and preventing relapse postpartum is a pivotal public health priority. <b><i>Objectives:</i></b> This study examined the risk and protective indicators of women who (a) smoke before pregnancy, (b) smoke during the entire pregnancy, (c) successfully quit smoking during pregnancy, and (d) relapse postpartum. <b><i>Method:</i></b> This paper reports secondary analyses of the Dutch population-based Monitor on Substance Use and Pregnancy (2016). A representative sample of mothers of young children (<i>n</i> = 1,858) completed questionnaires at youth health care centers. Bivariate and multivariate logistic regression analyses were conducted. <b><i>Results:</i></b> Main results showed that women’s smoking around pregnancy was strongly associated with the partner’s smoking status before pregnancy, partner’s change in smoking during pregnancy, and partner’s change in smoking postpartum. Women’s educational level and cannabis use before pregnancy were also related with women’s smoking before and during pregnancy. Women’s intensity of alcohol use before pregnancy was ambiguously related with women’s smoking before and during pregnancy. <b><i>Conclusions:</i></b> One of the key findings of this study suggests that it is essential that partners quit smoking before pregnancy and do not smoke during pregnancy. If partners continue smoking during pregnancy, they should quit smoking postpartum. Health care professionals can play an important role in addressing partners’ smoking and giving them evidence-based cessation support before, during, and after pregnancy.