Original Article

Cigarette Smoking During Pregnancy: Independent Associations with Religious Participation

Authors: R F. Gillum, MD, MSPH, D Paul Sullins, PhD

Abstract

Objective: Data from a national health survey were used to test the hypothesis of a negative association of smoking in pregnancy and three measures of religious participation and importance.


Methods: The 2002 National Survey of Family Growth included 2395 women aged 15 to 44 years with a history of at least one pregnancy in the five years before interview. An association between religious participation and cigarette smoking during the last pregnancy was assessed in bivariate and multivariate analyses.


Results: The rate of smoking during the last pregnancy was 4% (95% confidence limit [CL] 2–7%) among those who attended service more than once weekly and 24% (95% CL 20–30%) among those who never attended (chi-square 68, P < 0.0001). In logistic regression models compared with those who never attended, those attending once a week or more were only one-fifth as likely to smoke during pregnancy among European Americans (adjusted odds ratio with 95% confidence limits of 0.22, 0.12–0.39) and Hispanics (0.28 95% CL, 0.11–0.73), and one-half as likely to smoke among African Americans (0.53 95% CL, 0.16–1.69). Significant associations were also observed for affiliation and importance of religion.


Conclusion: The frequency of attendance at religious services, affiliation, and importance were independently inversely associated with smoking during pregnancy in American women. The strength of these associations varied among ethnic groups.


Key Points


* Women with active religious involvement were only one-fifth to one-half as likely to smoke during pregnancy as those with no involvement.


* The effect of religious participation was greatest in European Americans.


* Smokers who attended services weekly or more were nearly three times more likely to quit during pregnancy than those who never attended.


* Further research is needed to assess mechanisms for this association and to determine whether this information can be used to develop more effective intervention for smoking prevention and cessation in pregnancy.

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