title: Incident smoking during pregnancy and the postpartum period in a low-income urban population.
abstract: OBJECTIVE
  We determined the prevalence of first lifetime use of cigarettes during pregnancy or in the early postpartum period (incident smoking) and identified sociodemographic and health-related characteristics of incident smokers.
  
  
  METHODS
  We used statistics based on data from a longitudinal study of a large cohort of pregnant, low-income, urban women (n = 1,676) to describe the timing of first-time use and to compare incident smokers with those who had never smoked and those who had already smoked prior to pregnancy.
  
  
  RESULTS
  About one in 10 (10.2%) women who had not previously smoked initiated cigarette smoking during pregnancy or in the early postpartum period. Compared with those who had never smoked, incident smokers were more likely to report high levels of stress and to have elevated levels of depressive symptomatology, which may be rooted in relatively poor social and economic conditions.
  
  
  CONCLUSIONS
  A significant number of women may be initiating smoking during pregnancy or in the early postpartum period. These women have characteristics that are consistent with the risk factors associated with smoking. Further research is warranted to determine prevalence in other populations, identify the risk factors for incident smoking, and assess the potential for primary prevention efforts designed to help women who had previously avoided cigarette use to remain smoke-free throughout pregnancy and in the postpartum period.
authors.affiliation: Department of Adolescent Medicine, Children's Hospital of Philadelphia, 3535 Market St., Ste. 880, Philadelphia, PA 19104, USA. webbd@email.chop.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Webb
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Culhane
authors.forename: Leny
authors.initials: L
authors.lastname: Mathew
authors.forename: Joan R
authors.initials: JR
authors.lastname: Bloch
authors.forename: Robert L
authors.initials: RL
authors.lastname: Goldenberg
mesh_terms: D000328:Adult; D017668:Age of Onset; D016009:Chi-Square Distribution; D003863:Depression / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D015143:Philadelphia; D011159:Population Surveillance; D011203:Poverty / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D000074606:Smoking Prevention; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*