Women with lower levels of education are significantly less likely to give up smoking when pregnant and during their child’s early years than those who have been to university, according to US researchers.

Socioeconomic status and education have been linked to smoking before; however, large-scale studies of factors linked to maternal smoking are lacking. Dr Robert Kahn and colleagues from the Cincinnati Children’s Hospital Medical Center investigated factors related to poor pregnancy outcome using data obtained from the US National Maternal and Infant Health Survey. More than 8,000 women were included in the study and provided information on smoking habits before pregnancy, after conception and up to three years after delivery. Data obtained in 1988 and follow-up information obtained in 1991 showed that rates of smoking among women with a university degree fell by 30 per cent between the time before conception and three years after delivery. Women in the least educated group showed no change in smoking status over this time period, however. Women were less likely to give up smoking if they were on a low income, lived with another smoker, drank too much alcohol or had suffered depression. The researchers conclude that education levels are the strongest predictor of whether a woman will smoke before pregnancy and give up after conception or delivery. They add, “Health disadvantages associated with low maternal education are dynamic – they accrue over a time period that is rich in healthcare contacts.” Dr Kahn commented, “It is important to appreciate that these women also face higher hurdles along the way, including poverty, depression and the powerful cues of other household smokers.” “Ensuring continuous and comprehensive health services is critical for these women and for their children.” Reference: American Journal of Public Health, November 2002

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