{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:46:13Z","timestamp":1777898773424,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The Office of the Vice President for Research, University of South Carolina"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["3R01AI27203-5S2"],"award-info":[{"award-number":["3R01AI27203-5S2"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Pandemic-related worries and stressors were common during the COVID-19 pandemic. The objective of this study was to examine pandemic-related worries and stressors in relation to tobacco and alcohol use among postpartum women in the United States early in the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>From May through June 2020, 792 postpartum women in the United States completed an electronic survey, the COVID-19: Health in Pregnancy and Postpartum Study. The survey assessed pandemic-related worries by using a summary score of 10 items and pandemic-related stressors by using 4 items. The primary outcomes were tobacco and alcohol use. Secondary outcomes were increased amounts of tobacco and alcohol during the pandemic among participants who used tobacco and\/or alcohol. We used logistic regression models to examine the association of pandemic-related worries and stressors with each outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among postpartum women, 24.4% used tobacco and 27.8% used alcohol. Pandemic-related worries were associated with higher odds of tobacco use (adjusted odds ratio [AOR]\u2009=\u20091.08; 95% CI, 1.04-1.13), alcohol use (AOR\u2009=\u20091.09; 95% CI, 1.05-1.13), and using both tobacco and alcohol postpartum (AOR\u2009=\u20091.13; 95% CI, 1.07-1.20). Both worries and stressors were associated with increased tobacco use (AOR for worries\u2009=\u20091.08; 95% CI, 1.01-1.16; AOR for stressors\u2009=\u20092.00; 95% CI, 1.33-3.00) but not with increased alcohol use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The association between pandemic-related worries and stressors and tobacco use underscores the need for health promotion interventions among postpartum women to reduce tobacco use. Developing pandemic-related interventions now for use in future pandemics to alleviate pandemic-related worries and stressors experienced by postpartum women is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00333549251372048","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T12:42:14Z","timestamp":1761828134000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pandemic-Related Worries and Stressors and Use of Tobacco and Alcohol Among Postpartum Women in the United States Early in the COVID-19 Pandemic"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3056-1894","authenticated-orcid":false,"given":"Xuanxuan","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8685-3036","authenticated-orcid":false,"given":"Jihong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA"},{"name":"Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peiyin","family":"Hung","sequence":"additional","affiliation":[{"name":"Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA"},{"name":"Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anwar","family":"Merchant","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony J.","family":"Alberg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113347"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17051729"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/aphw.12234"},{"issue":"8","key":"e_1_3_2_5_2","first-page":"485","article-title":"Postpartum care: an approach to the fourth trimester","volume":"100","author":"Paladine HL","year":"2019","unstructured":"Paladine HL, Blenning CE, Strangas Y. Postpartum care: an approach to the fourth trimester. Am Fam Physician. 2019;100(8):485-491.","journal-title":"Am Fam Physician"},{"key":"e_1_3_2_6_2","unstructured":"Centers for Disease Control and Prevention. Pregnant & postpartum activity: an overview. November 28 2023. Accessed November 23 2024. https:\/\/www.cdc.gov\/physical-activity-basics\/guidelines\/healthy-pregnant-or-postpartum-women.html"},{"issue":"2","key":"e_1_3_2_7_2","first-page":"22","article-title":"Postpartum period: three distinct but continuous phases","volume":"4","author":"Romano M","year":"2010","unstructured":"Romano M, Cacciatore A, Giordano R, La Rosa B. Postpartum period: three distinct but continuous phases. J Prenat Med. 2010;4(2):22-25.","journal-title":"J Prenat Med"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2013.09.002"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/17455065211042190"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2196\/30422"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-04241-2"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.08.018"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/S11606-021-06913-3"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18041795"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2020.1866657"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.571084"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17249189"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2020.106754"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.7326\/M20-7271"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2014.02.001"},{"key":"e_1_3_2_21_2","volume-title":"The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General","author":"US Department of Health and Human Services","year":"2006","unstructured":"US Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Centers for Disease Control and Prevention; 2006."},{"key":"e_1_3_2_22_2","volume-title":"How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease","author":"US Department of Health and Human Services","year":"2010","unstructured":"US Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease. Centers for Disease Control and Prevention; 2010."},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/imhj.20342"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcop.20062"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-057989"},{"key":"e_1_3_2_26_2","unstructured":"Centers for Disease Control and Prevention. Breastfeeding special circumstances: alcohol. February 26 2025. Accessed November 19 2024. https:\/\/www.cdc.gov\/breastfeeding-special-circumstances\/hcp\/vaccine-medication-drugs\/alcohol.html"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2021.102929"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12554"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/13591053030086008"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-02862-w"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynstr.2019.100149"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogn.2017.01.012"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7111a1"},{"key":"e_1_3_2_34_2","unstructured":"American College of Obstetricians and Gynecologists. Alcohol and women: frequently asked questions. June 2023. Accessed November 19 2024. https:\/\/www.acog.org\/womens-health\/faqs\/alcohol-and-women"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.15620\/CDC:112079"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntr313"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.5888\/pcd18.200547"},{"key":"e_1_3_2_38_2","unstructured":"Centers for Disease Control and Prevention. Tobacco Product Use Among Adults\u2014United States 2022. 2022. Accessed January 20 2025. https:\/\/www.cdc.gov\/tobacco\/media\/pdfs\/2024\/09\/cdc-osh-ncis-data-report-508.pdf"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2020.102271"},{"key":"e_1_3_2_40_2","unstructured":"American College of Obstetricians and Gynecologists. Committee opinion: optimizing postpartum care. May 2018. Accessed November 19 2024. https:\/\/www.acog.org\/clinical\/clinical-guidance\/committee-opinion\/articles\/2018\/05\/optimizing-postpartum-care"}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549251372048","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00333549251372048","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549251372048","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:40:35Z","timestamp":1777628435000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00333549251372048"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":39,"alternative-id":["10.1177\/00333549251372048"],"URL":"https:\/\/doi.org\/10.1177\/00333549251372048","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,30]]},"article-number":"00333549251372048"}}