Delayed first pregnancy among African-American adolescent smokers.
OBJECTIVE
This study aimed to compare rates of adolescent pregnancy among African-American adolescents who began smoking as adolescents with those who did not.


METHODS
Cross-sectional data on 1042 primiparous African-American women enrolled in a randomized clinical trial of nurse home visitation were examined. The independent variable, adolescent smoking, was defined as a report of smoking before the age of 18 years. The outcome variable was adolescent pregnancy, defined as first pregnancy before the age of 18 years. Logistic regression was used to control for potential confounders.


RESULTS
After adjustments for drug use, use of contraception, frequency of coitus, and sexually transmitted diseases, women who smoked during adolescence had a 50% lower risk of becoming pregnant as an adolescent [odds ratio of 0.46 (95% confidence interval [CI] 0.27-0.76)]. When time to first pregnancy was examined as a continuous variable, adolescent smoking was associated with a delay in pregnancy of 22.6 months (95% CI 16.8-29.2).


CONCLUSIONS
Teen smoking appears to be associated with a significantly lower rate of adolescent pregnancy among African-Americans. Although the nature of this relationship is unclear, this finding suggests the need for linkage between smoking prevention and adolescent pregnancy prevention.
Department of Family Medicine, University of Rochester School of Medicine, New York, USA.
K
K
Fiscella
H J
HJ
Kitzman
R E
RE
Cole
K
K
Sidora
D
D
Olds
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005298:Fertility / Q000187:drug effects; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control / Q000706:statistics & numerical data*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D000074606:Smoking Prevention; D013714:Tennessee / Q000453:epidemiology