Timing of Prenatal Smoking Cessation or Reduction and Infant Birth Weight: Evidence from the United Kingdom Millennium Cohort Study
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Smoking during pregnancy is a key contributor to poor infant health. Our study presents a dynamic relationship between the timing of prenatal smoking cessation or reduction and infant birth weight. Using a large representative dataset of a birth cohort in the United Kingdom, we apply regression analysis to examine the influences of cessation in smoking or reduction in smoking intensity at different months or trimesters on infant birth weight. For robustness checks, we use a rich set of additional covariates, a series of variable selection procedures, alternative birth outcome measures, and stratified samples. We find robust evidence that mothers who quit smoking by the third month of pregnancy or the end of the first trimester have infants of the same weight as those infants of nonsmokers. However, we find smoking cessation in the fourth month or any time beyond is associated with substantially lower infant birth weights. Two-thirds of the total adverse smoking impact on infant birth weight occurs in the second trimester. Our study also shows mothers who smoke throughout pregnancy but cut smoking intensity by the third month in pregnancy deliver infants of the same weight as those infants born to persistent light smokers. Our research suggests the efficacy of prenatal smoking cessation services can be significantly improved, if health professionals can encourage more pregnant women to quit smoking or reduce smoking intensity timely by the end of the first trimester.
KeywordsPrenatal smoking Timing of smoking cessation Timing of smoking reduction Birth weight
The authors thank helpful comments of Arnie Aldridge, Albert Baernstein, Meghan Bailey, Sarah W. Ball, Jimin Ding, Bart Hamilton, Tim McBride, Karen Norberg, Michelle D. Hoersch, Longjian Liu, Bob Pollak, Robin H. Pugh-Yi, Stanley Sawyer, Mary A. Steiner, Emma Winter, and other participants of seminars in Washington University in Saint Louis and 2011 American Public Health Association Annual Meeting.
- 1.Simpson, W. J. (1957). A preliminary report on cigarette smoking and the incidence of prematurity. American Journal of Obstetrical & Gynecological, 73, 808–815.Google Scholar
- 5.US Department of Health and Human Services. (2001). Women and smoking: A report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Office of the Surgeon General.Google Scholar
- 6.Ghodse, H., Herrman, H., Maj, M., & Sartorius, N. (2011). Substance abuse disorders: Evidence and experience (Vol. 23). Oxford, UK: Wiley.Google Scholar
- 7.Tong, V. T., Jones, J. R., Dietz, P. M., D’ Angelo, D., & Bombard, J. M. (2009). Trends in smoking before, during, and after pregnancy: Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 31 sites, 2000–2005. Morbidity and Mortality Weekly Report, 58(39), 911–915.Google Scholar
- 8.Bolling, K. (2006). Infant Feeding Survey 2005: Early results. Leeds, UK: UK Information Centre for Health and Social Care.Google Scholar
- 9.Department of Health. (1999). Smoking kills: A white paper on tobacco. London, UK: Stationery Office.Google Scholar
- 19.Lindley, A. A., Becker, S., Gray, R. H., & Herman, A. A. (2000). Effect of continuing or stopping smoking during pregnancy on infant birth weight, crown-heel length, head circumference, ponderal index, and brain: Body weight ratio. American Journal of Epidemiology, 152(3), 219–225.CrossRefPubMedGoogle Scholar
- 30.Bell, K., McCullough, L., Greaves, L., Bauld, L., Mulryne, R., Jategaonkar, N., et al. (2006). The effectiveness of National Health Service intensive treatments for smoking cessation in England: A systematic review. London, UK: National Institute for Clinical and Health Excellence.Google Scholar
- 32.Lumley, J., Chamberlain, C., Dowswell, T., Oliver, S., Oakley, L., & Watson, L. (2009). Interventions for promoting smoking cessation during pregnancy. Cochrane Database Systematic Reviews, 3, 1–136.Google Scholar