Recent Stressful Events Linked With Smoking During Pregnancy

Stress and cigarette smoking seem to go hand-in-hand with each other as many people, especially women, report smoking to relieve stress. The perinatal period (including pregnancy and postpartum, the period after delivery) is also known to be a stressful time. We completed a study to examine the relationship between stressful life events (such as losing a job or moving) with cigarette smoking during the perinatal period.

Using data from 15,136 women who completed the Pregnancy Risk Assessment Monitoring System (PRAMS) survey in 2009-2011, we sought to answer two questions. First, if women had more stressful life events, were they more likely to continue smoking during pregnancy? Second, among the women who quit smoking during pregnancy, were those who had more stressful life events more likely to go back to smoking after pregnancy? To do this, we looked at cigarette smoking before pregnancy, during pregnancy, and after pregnancy. We also looked at the number of stressful life events women reported in the year prior to pregnancy. We asked about the following 13 events: husband/partner lost job, mom lost job, had a lot of bills that couldn’t be paid, moved to a new address, was homeless, someone close to mom died, got separated/divorced, argued with husband/partner more, husband/partner or mom went to jail, was in a physical fight, husband/partner didn’t want mom to be pregnant, someone close to mother had a drug or alcohol problem.

Women who continued to smoke pregnancy were more likely to experience six different stressful life events. Specifically, they were 24% more likely to report the death of someone close to them, 45% more likely to report having bills they couldn’t pay, 55% more likely to report someone close had a drug or alcohol problems, 70% more likely to report being in a physical fight, 75% more likely to report husband/partner or mom went to jail, and 103% more likely to report homelessness.

In contrast, women who returned to smoking after having their baby were more likely to experience just one stressful life event. Specifically, women who went back to smoking after having their baby were 36% more likely to report they experienced the death of someone close to them.

Overall, this indicates there is a link between recent stressful events and perinatal smoking. This link may be especially strong smoking during pregnancy, given six stressful events were linked to smoking during pregnancy whereas just one was linked to smoking after pregnancy. It is important to note that we were unable to determine which happened first – the stressful event or the smoking. That is to say, we do not know if the stressful life event caused the smoking or if they just happened to occur more often in the same person. However, the next step in this line of work is to explore how management of stress may help women quit smoking during pregnancy, perhaps through meditation or counseling. Because smoking during pregnancy causes a wide range of health problems for both mom and baby (such as premature birth and low birth weight), stress management during pregnancy may help women quit smoking and improve their health, as well as the health of the baby.