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Factors Associated With Early Smoking Cessation in Teenage Pregnancies [91]

INTRODUCTION: The prevalence of smoking in teen mothers is high, 15% nationally and 34% in Ohio. Both young maternal age and cigarette smoking are independently associated with adverse pregnancy outcomes. We aim to identify factors associated with smoking cessation and quantify their relative effect in teen pregnancies. METHODS: A population-based retrospective cohort study of all Ohio live births, 2006–2012. Teen mothers aged younger than 20 years who quit smoking in the first trimester were compared with a referent group of teens who smoked throughout pregnancy. Logistic regression assessed the association between demographic and prenatal factors and odds of smoking cessation. RESULTS: Of 1,003,532 births, 10% were to mothers younger than age 20 years. Of these mothers, nearly one third (31%) smoked in the 3 months preconception. Of smokers, 21% quit in the first trimester and more than half (58%) smoked throughout pregnancy. Factors associated with a higher likelihood of early smoking cessation included black race (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.6–1.9) and early prenatal care (12 weeks of gestation, OR 1.4, 95% CI 1.3–1.5). Factors negatively associated with smoking cessation in teens were: five or fewer prenatal care visits (OR 0.7, 95% CI 0.6–0.8), previous preterm birth (OR 0.5, 95% CI 0.3–0.6), Medicaid (OR 0.6, 95% CI 0.5–0.6), and heavy smoking (20 cigarettes per day, OR 0.5, 95% CI 0.4–0.5). Obesity, marital status, and age stratum (younger than 15, 15–17, 18–19 years) did not influence smoking cessation. CONCLUSION: Most teens who smoke do not quit in pregnancy, and those who continue to smoke commonly have additional risk factors for adverse outcomes. Early care for pregnant teens is especially important considering the 36% increased odds of smoking cessation with first-trimester initiation of prenatal care in this group who are particularly high risk for poor perinatal outcomes.