title: A reexamination of smoking before, during, and after pregnancy.
abstract: OBJECTIVE
  This study examined the patterns and correlates of maternal smoking before, during, and after pregnancy.
  
  
  METHODS
  We examined socioeconomic, demographic, and clinical risk factors associated with maternal smoking in a nationally representative cohort of women (n = 8285) who were surveyed 17 +/- 5 months and again 35 +/- 5 months after delivery.
  
  
  RESULTS
  Smoking rates among women with a college degree decreased 30% from before pregnancy to 35 months postpartum but did not change among the least educated women. Risk factors clustered, and a gradient linked the number of risk factors (0, 2, 4) to the percentage smoking (6%, 31%, 58%, P <.0001).
  
  
  CONCLUSIONS
  The period of pregnancy and early parenthood is associated with worsening education-related disparities in smoking as well as substantial clustering of risk factors. These observations could influence the targeting and design of maternal smoking interventions.
authors.affiliation: Division of General and Community Pediatrics, Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. robert.kahn@chmcc.org
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kahn
authors.forename: Laura
authors.initials: L
authors.lastname: Certain
authors.forename: Robert C
authors.initials: RC
authors.lastname: Whitaker
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D015438:Health Behavior; D006801:Humans; D009035:Mothers / Q000523:psychology*; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D037841:Pregnant People / Q000523:psychology*; D015995:Prevalence; D011336:Probability; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000208:ethnology; D016540:Smoking Cessation / Q000523:psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology