The Role of Childbirth in Smoking Cessation

Background. Many women abstain from smoking during pregnancy, but relapse rates in the first year postpartum are high. The impact of childbirth on long-term abstinence from smoking is unknown for both women and men. Methods. We assessed the impact of childbirth on long-term abstinence from smoking (minimum: 17 months, much longer in most cases) in a retrospective cohort analysis of 925 women and 1,494 men who were interviewed in 1984 to 1986 in the national baseline survey of the German Cardiovascular Prevention Study. Results. Among women, smoking cessation rates resulting in long-term abstinence were about three times higher during the year of childbirth and the year before than in other years (adjusted rate ratio, 2.98; 95% confidence interval, 2.21–4.03). Childbirth was also associated with increased cessation rates among better educated men (adjusted rate ratio for this subgroup, 1.84; 95% confidence interval, 1.16–2.92), but not among less educated men. Nevertheless, childbirth led to long-term abstinence from smoking only in a small minority of smoking mothers and fathers. Conclusion. Despite increased cessation rates around childbirth, more effective measures are needed to promote sustained abstinence after childbirth among both parents.