{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:35:38Z","timestamp":1790922938942,"version":"4.1.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,11,19]],"date-time":"2022-11-19T00:00:00Z","timestamp":1668816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 DA021608"],"award-info":[{"award-number":["R01 DA021608"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01 DA021608"],"award-info":[{"award-number":["R01 DA021608"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Previous work has identified predictors of relapse to smoking postpartum among parenting people who quit during pregnancy, but less is known about the time course of postpartum relapse. The study goals were to document patterns and correlates of smoking resumption among people who quit smoking during pregnancy and were motivated to remain abstinent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims and Methods<\/jats:title><jats:p>We conducted a secondary analysis among participants in a randomized controlled trial of postpartum-specific smoking relapse prevention interventions who self-reported no smoking since the quit date to delivery (n = 280). Participants provided expired air samples of carbon monoxide, and completed self-report measures of mood, perceived stress, and demographic and pregnancy-related information. Timeline follow-back interviews were conducted at the end of pregnancy and 12-, 24-, and 52-weeks postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The largest group (49.7% of participants) belonged to a trajectory reflecting abstinence across 1 year postpartum. Another 13% remained abstinent 5\u20136 months after delivery. However, one in five started to smoke consistently within 100 days after delivery, and 16% relapsed in a pattern that can be described as inconsistent smoking. Participants with more prior quit attempts and those who smoked more cigarettes prior to their quit attempt were more likely to relapse within 100 days of delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The first 3 months postpartum represent a critical window for relapse prevention, given that most individuals who relapsed did so in the first 100 days or so after delivery. Assessing prior smoking history can help identify pregnant people who will need additional support in the early postpartum period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications<\/jats:title><jats:p>Relapse to smoking during the year after childbirth is common, but the time course of relapse after delivery is poorly understood. This study provides evidence for 4 distinct trajectories of relapse, and highlights variables linked to early relapse that may improve efforts to target and time intervention efforts. Specifically, assessing age at initiation, quantity of tobacco use prior to quit attempt, and number of previous quit attempts will identify pregnant people at greatest risk of early relapse. These findings also suggest that additional support early in the postpartum period is crucial for most people in the postpartum who will relapse.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ntr\/ntac263","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T22:23:58Z","timestamp":1668723838000},"page":"875-881","source":"Crossref","is-referenced-by-count":6,"title":["Trajectories of Return to Cigarette Smoking Up to 1 Year Postpartum Among People Who Quit Smoking During Pregnancy"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8264-3485","authenticated-orcid":false,"given":"Natacha M","family":"De Genna","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh School of Medicine and Department of Epidemiology, University of Pittsburgh School of Public Health , 3811 O\u2019Hara St, Pittsburgh, PA 15213 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Pittsburgh , 1818 Wesley W. Posvar Hall, Pittsburgh, PA 15213 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4805-203X","authenticated-orcid":false,"given":"Yu","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Pittsburgh , 1818 Wesley W. Posvar Hall, Pittsburgh, PA 15213 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca L","family":"Emery Tavernier","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School , 141 Smed. 1035 University Drive, Duluth, MN 55812-303 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5107-1146","authenticated-orcid":false,"given":"Rachel P","family":"Kolko Conlon","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh School of Medicine , 3811 O\u2019Hara St, Pittsburgh, PA 15213 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele D","family":"Levine","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry, Psychology, and Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine and Department of Psychology, University of Pittsburgh , 3811 O\u2019Hara St, Pittsburgh, PA 15213 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,11,19]]},"reference":[{"issue":"1","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12884-020-2748-y","article-title":"Trends in smoking during pregnancy by socioeconomic characteristics in the United States, 2010\u20132017","volume":"20","author":"Azagba","year":"2020","journal-title":"BMC Pregnancy Childbirth."},{"key":"2023040612443149300_","author":"Centers for Disease Control."},{"issue":"6","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1093\/ntr\/ntx118","article-title":"Postpartum changes in mood and smoking-related symptomatology: an ecological momentary assessment investigation","volume":"20","author":"Allen","year":"2018","journal-title":"Nicotine Tob Res."},{"key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.ypmed.2018.11.012","article-title":"Stressful life events are associated with perinatal cigarette smoking","volume":"118","author":"Allen","year":"2019","journal-title":"Prev Med."},{"issue":"3","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/S0749-3797(00)00198-7","article-title":"Correlates of postpartum smoking relapse: results from the Pregnancy Risk Assessment Monitoring System (PRAMS)","volume":"19","author":"Carmichael","year":"2000","journal-title":"Am J Prev Med."},{"issue":"6","key":"2023040612443149300_","first-page":"1","article-title":"Trends in smoking before, during, and after pregnancy\u2014Pregnancy Risk Assessment Monitoring System, United States, 40 sites, 2000\u20132010.","volume":"62","author":"Tong","year":"2013","journal-title":"MMWR: Surveill Summ"},{"issue":"5","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1093\/oxfordjournals.aje.a116857","article-title":"Are female smokers at higher risk for lung cancer than male smokers? A case-control analysis by histologic type","volume":"138","author":"Risch","year":"1993","journal-title":"Am J Epidemol."},{"issue":"4","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1056\/NEJMsa1211127","article-title":"50-year trends in smoking-related mortality in the United States","volume":"368","author":"Thun","year":"2013","journal-title":"N Engl J Med."},{"issue":"9760","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S0140-6736(10)61388-8","article-title":"Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries","volume":"377","author":"\u00d6berg","year":"2011","journal-title":"Lancet."},{"issue":"6","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"e0157525","DOI":"10.1371\/journal.pone.0157525","article-title":"\u201cI was a full time proper smoker\u201d: a qualitative exploration of smoking in the home after childbirth among women who relapse postpartum","volume":"11","author":"Orton","year":"2016","journal-title":"PLoS One."},{"issue":"6","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1093\/ntr\/ntx163","article-title":"Predictors of postpartum return to smoking: a systematic review","volume":"20","author":"Orton","year":"2018","journal-title":"Nicotine Tob Res."},{"issue":"11","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1111\/add.13062","article-title":"Postpartum smoking relapse\u2014a thematic synthesis of qualitative studies","volume":"110","author":"Notley","year":"2015","journal-title":"Addiction."},{"issue":"6","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1007\/s10995-020-03019-w","article-title":"Factors associated with smoking relapse in the early postpartum period: a prospective longitudinal study in Spain","volume":"25","author":"M\u00edguez","year":"2021","journal-title":"Matern Child Health."},{"issue":"5","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1007\/s10995-018-2434-0","article-title":"Transitions in smoking across a pregnancy: new information from the growing up in New Zealand longitudinal study","volume":"22","author":"Schilling","year":"2018","journal-title":"Matern Child Health."},{"issue":"7","key":"2023040612443149300_","first-page":"810","article-title":"Nondaily smokers\u2019 characteristics and likelihood of prenatal cessation and postpartum relapse","volume":"19","author":"Rockhill","year":"2017","journal-title":"Nicotine Tob Res."},{"issue":"3","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1159\/000498988","article-title":"Smoking behavior of women before, during, and after pregnancy: indicators of smoking, quitting, and relapse","volume":"25","author":"Scheffers-van Schayck","year":"2019","journal-title":"Eur Addict Res."},{"issue":"1","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.amepre.2008.09.020","article-title":"Postpartum depressive symptoms and smoking relapse","volume":"36","author":"Allen","year":"2009","journal-title":"Am J Prev Med."},{"issue":"4","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.jogn.2020.05.006","article-title":"Smoking status and symptoms of depression during and after pregnancy among low-income women","volume":"49","author":"Jones","year":"2020","journal-title":"J Obstet Gynecol Neonatal Nurs."},{"issue":"6","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1093\/ntr\/ntp053","article-title":"The association of depressive, anxiety, and stress symptoms and postpartum relapse to smoking: a longitudinal study","volume":"11","author":"Park","year":"2009","journal-title":"Nicotine Tob Res."},{"issue":"11","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"e018746","DOI":"10.1136\/bmjopen-2017-018746","article-title":"Smoking and quit attempts during pregnancy and postpartum: a longitudinal UK cohort","volume":"7","author":"Cooper","year":"2017","journal-title":"BMJ Open."},{"issue":"3","key":"2023040612443149300_","first-page":"232","article-title":"Prenatal and postpartum smoking abstinence: a partner-assisted approach","volume":"27","author":"McBride","year":"2004","journal-title":"Am J Prev Med."},{"issue":"4","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1080\/14622200500185371","article-title":"The return to smoking: 1-year relapse trajectories among female smokers","volume":"7","author":"Conklin","year":"2005","journal-title":"Nicotine Tob Res."},{"issue":"2","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.cct.2013.10.002","article-title":"Strategies to Avoid Returning to Smoking (STARTS): a randomized controlled trial of postpartum smoking relapse prevention interventions","volume":"36","author":"Levine","year":"2013","journal-title":"Contemp Clin Trials."},{"issue":"4","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1001\/jamainternmed.2016.0248","article-title":"Preventing postpartum smoking relapse: a randomized clinical trial","volume":"176","author":"Levine","year":"2016","journal-title":"JAMA Intern Med."},{"issue":"9","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1111\/j.1360-0443.1991.tb01879.x","article-title":"The Fagerstr\u00f6m test for nicotine dependence: a revision of the Fagerstr\u00f6m Tolerance Questionnaire","volume":"86","author":"Heatherton","year":"1991","journal-title":"Br J Addict."},{"issue":"3","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1037\/0022-006X.58.3.310","article-title":"Intrinsic and extrinsic motivation for smoking cessation","volume":"58","author":"Curry","year":"1990","journal-title":"J Consult Clin Psychol."},{"issue":"2","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1037\/0893-164X.15.2.126","article-title":"Motivation for smoking cessation among pregnant women","volume":"15","author":"Curry","year":"2001","journal-title":"Psychol Addict Behav."},{"issue":"6","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1046\/j.1360-0443.2000.9569017.x","article-title":"Development and validation of a scale measuring self-efficacy of current and former smokers","volume":"95","author":"Etter","year":"2000","journal-title":"Addiction."},{"issue":"1","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/1462220031000070552","article-title":"Measures of abstinence in clinical trials: issues and recommendations","volume":"5","author":"Hughes","year":"2003","journal-title":"Nicotine Tob Res."},{"issue":"2","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1037\/0893-164X.12.2.101","article-title":"Reliability and validity of a smoking timeline follow-back interview","volume":"12","author":"Brown","year":"1998","journal-title":"Psychol Addict Behav."},{"issue":"1","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1037\/a0030992","article-title":"Reliability of the Timeline Followback for cocaine, cannabis, and cigarette use","volume":"28","author":"Robinson","year":"2014","journal-title":"Psychol Addict Behav."},{"issue":"3","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The CES-D scale: a self-report depression scale for research in the general population","volume":"1","author":"Radloff","year":"1977","journal-title":"Appl Psychol Meas."},{"issue":"4","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress","volume":"24","author":"Cohen","year":"1983","journal-title":"J Health Soc Behav."},{"key":"2023040612443149300_","volume-title":"Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID)","author":"First","year":"1997"},{"issue":"5","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/S0306-4603(98)00014-8","article-title":"The role of weight concern and self-efficacy in smoking cessation and weight gain among smokers in a clinic-based cessation program","volume":"23","author":"Borrelli","year":"1998","journal-title":"Addict Behav."},{"key":"2023040612443149300_","doi-asserted-by":"crossref","DOI":"10.4324\/9781315642741","volume-title":"Higher-order Growth Curves and Mixture Modeling with Mplus","author":"Wickrama","year":"2016"},{"issue":"6","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1037\/a0025132","article-title":"The role of prepartum motivation in the maintenance of postpartum smoking abstinence","volume":"30","author":"Heppner","year":"2011","journal-title":"Health Psychol."},{"issue":"3","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.whi.2019.03.006","article-title":"The role of self-efficacy and motivation in postpartum sustained smoking abstinence","volume":"29","author":"Germeroth","year":"2019","journal-title":"Womens Health Issues."},{"issue":"1","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1037\/a0024451","article-title":"Relapse dynamics during smoking cessation: recurrent abstinence violation effects and lapse-relapse progression","volume":"121","author":"Kirchner","year":"2012","journal-title":"J Abnorm Psychol."},{"key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"106352","DOI":"10.1016\/j.cct.2021.106352","article-title":"Bupropion for postpartum smoking relapse: a remote protocol for a two-arm, double-blind, placebo-controlled randomized clinical trial","volume":"105","author":"Allen","year":"2021","journal-title":"Contemp Clin Trials."},{"issue":"3","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1080\/10705511.2016.1247646","article-title":"The GRoLTS-checklist: guidelines for reporting on latent trajectory studies","volume":"24","author":"Van De Schoot","year":"2017","journal-title":"Struct Equ Model."},{"issue":"5","key":"2023040612443149300_","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1089\/jwh.2015.5244","article-title":"Postpartum smoking relapse after quitting during pregnancy: pregnancy risk assessment monitoring system, 2000\u20132011","volume":"25","author":"Rockhill","year":"2016","journal-title":"J Women\u2019s Health (Larchmt)."},{"issue":"2","key":"2023040612443149300_","first-page":"CD003999","article-title":"Relapse prevention interventions for smoking cessation","volume":"2","author":"Livingstone-Banks","year":"2019","journal-title":"Cochrane Database Syst Rev."}],"container-title":["Nicotine &amp; Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntac263\/49255592\/ntac263.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/25\/5\/875\/49783989\/ntac263.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/25\/5\/875\/49783989\/ntac263.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T10:08:25Z","timestamp":1701425305000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/article\/25\/5\/875\/6834112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,19]]},"references-count":43,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,11,19]]},"published-print":{"date-parts":[[2023,4,6]]}},"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntac263","relation":{},"ISSN":["1469-994X"],"issn-type":[{"value":"1469-994X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,5,1]]},"published":{"date-parts":[[2022,11,19]]}}}