Smoking in the home after childbirth: prevalence, determinants and the relationship to smoking in pregnancy

Orton, Sophie (2016) Smoking in the home after childbirth: prevalence, determinants and the relationship to smoking in pregnancy. PhD thesis, University of Nottingham.

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Childhood secondhand smoke (SHS) exposure causes substantial ill health and mortality, and poses a significant economic and social burden. This thesis aimed to explore the prevalence and determinants of smoking in the home after childbirth, and to understand the experience and attitudes of mothers who stop smoking during pregnancy but relapse soon after delivery.

In study one, the factors associated with child SHS exposure in the home were systematically reviewed. Parental smoking, low socioeconomic status and being less educated were all frequently and consistently independently associated with children’s SHS exposure in the home. Children whose parents held more negative attitudes towards SHS were less likely to be exposed.

In study two, cohort data were analysed to estimate maternal self-reported prevalence of SHS exposure among young infants (≤3 months) of women who smoked just before or during pregnancy, and identify its associated factors. In 471 households, the prevalence of smoking in the home was 16.3% (95% CI 13.2-19.8%), and after multiple imputation controlling for non-response 18.2% (95% CI 14.0-22.5%). Mothers’ smoking ≥11 cigarettes per day were 8.2 times (95% CI 3.4-19.6) more likely to report smoking in the home. Significant associations were also observed for younger age, being of non-White ethnicity, increased deprivation and less negative attitudes towards SHS.

In study three, semi-structured interviews with women who quit smoking during pregnancy, but relapsed ≤3 months postpartum were conducted. Central to mothers’ accounts of their smoking behaviours during pregnancy and postpartum was their desire to be a ‘responsible mother’. Mothers described using strategies to protect their infant from SHS exposure, and held strong negative attitudes towards other smoking parents. After relapsing, mothers repositioned themselves as ‘social/occasional’ smokers rather than ‘regular’ smokers.

Taken together, these findings can be used to inform the development of future, targeted interventions to prevent or reduce infant and child SHS exposure.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Coleman, T.J.
Jones, Laura L.
Lewis, S.
Cooper, S.
Keywords: Smoking, Secondhand smoke, Infant
Subjects: W Medicine and related subjects (NLM Classification) > WM Psychiatry
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 31223
Depositing User: Orton, Sophie
Date Deposited: 19 Jul 2016 06:40
Last Modified: 01 Jan 2018 21:38

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