title: Maternal trajectories of cigarette use as a function of maternal age and race.
abstract: Patterns of smoking vary as a function of age and race. The goals of this study were to identify trajectories of maternal cigarette use over a 17-year span, and to determine if maternal age at first birth and race were associated with smoking trajectories.
  
  
  
  Pregnant women (N=690) were recruited at an urban prenatal clinic. The women (13-42years old; 62% African-American, 38% White) were interviewed about cigarette use during pregnancy and 6, 10, 14, and 16years postpartum. Growth mixture modeling (GMM) was used to identify trajectories. Regressions were used to determine if maternal age at first birth and race predicted trajectory class membership.
  
  
  
  A GMM of maternal cigarette use delineated 5 groups: none/unlikely to use (33%), decreasing likelihood of use (6%), late desistance (5%), increasing likelihood of use (17%), and chronic use (39%). Women who became mothers at a younger age were more likely to be classified as late desisters or increasingly likely to smoke. White mothers were more likely to be chronic smokers. Different smoking trajectories and predictors of trajectories were identified for the African-American and White mothers. Covariates including prenatal substance use, hostility, education, and economic hardship also differentiated smoking trajectories.
  
  
  
  Both prevention and treatment of smoking should be targeted to specific groups by age of first pregnancy and race. Pregnant smokers should be provided with more information and resources to help them avoid cigarettes during pregnancy and maintain abstinence after pregnancy.
authors.affiliation: University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. Electronic address: degennan@pitt.edu.
authors.forename: Natacha Marie
authors.initials: NM
authors.lastname: De Genna
authors.affiliation: University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. Electronic address: lidush@pitt.edu.
authors.forename: Lidush
authors.initials: L
authors.lastname: Goldschmidt
authors.affiliation: University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. Electronic address: nday@pitt.edu.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Day
authors.affiliation: University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. Electronic address: mdc1@pitt.edu.
authors.forename: Marie D
authors.initials: MD
authors.lastname: Cornelius
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000073865:Cigarette Smoking / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008423:Maternal Age; D009035:Mothers / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D044469:Racial Groups / Q000706:statistics & numerical data; D012307:Risk Factors; D014505:Urban Population; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Desistance; Maternal; Mother; Smoking; Tobacco; Women