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2019 HSR&D/QUERI National Conference Abstract

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1035 — Factors associated with quitting smoking during pregnancy among women Veterans who were smoking at the beginning of their pregnancy

Lead/Presenter: Lindsey Russo,  COIN - West Haven
All Authors: Russo LM (VA Connecticut Healthcare System, West Haven, CT), ; DeRycke EC (VA Connecticut Healthcare System, West Haven, CT), ; Bastian LA (VA Connecticut Healthcare System, West Haven, CT; Department of General Internal Medicine, Yale University School of Medicine, New Haven, CT); Holzhauer CG (VA Central Western Massachusetts Healthcare System, Leeds, MA; Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA); Kinney R (VA Central Western Massachusetts Healthcare System, Leeds, MA); Mattocks KM (VA Central Western Massachusetts Healthcare System, Leeds, MA; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA)

Objectives:
Women Veterans are more likely to smoke cigarettes than civilian women. However, little is known about the rates of smoking among pregnant women Veterans. The objective was to examine rates of smoking at the beginning of pregnancy and then understand factors associated with quitting smoking during the first 20 weeks of pregnancy.

Methods:
The Center for Maternal and Infant Outcomes Research in Translation (COMFORT) is a multisite study of pregnant and postpartum Veterans (n = 674) at 15 VA facilities nationwide. Baseline telephone surveys were conducted with women at 20 weeks of pregnancy. Multivariable logistic regression was used to estimate unadjusted and adjusted odds of quitting smoking during pregnancy for demographic and clinical factors.

Results:
Overall, 108 Women Veterans (16%) reported smoking at the beginning of their pregnancy on the baseline survey. Among this group of smokers, the average age was 33, 16% were Black, and 11% were Hispanic/Latino. Overall, there were high rates of depression (71%), PTSD (56%), and military sexual trauma (59%). Seventy women (65%) quit smoking by 20 weeks of pregnancy. Factors associated with quitting smoking compared to continued smoking during their pregnancy included whether this was their first pregnancy (40% vs. 18%, P = .02) and a history of deployment (71% vs. 49%, P = .03). In multivariable analysis, adjusting for military sexual trauma, higher odds of quitting smoking were observed for first pregnancy (OR = 2.90, 95% CI: 1.07-7.88) and history of deployment (OR = 2.47, 95% CI: 1.02, 5.97) among women Veterans.

Implications:
First pregnancy and deployment history were associated with quitting smoking during pregnancy.

Impacts:
Women Veterans affiliated with VA hospitals across the US who quit smoking during pregnancy may be different than those that continue to smoke during this period. Pre-conception counseling should focus on smoking cessation for Women Veterans.