{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:23:15Z","timestamp":1773274995029,"version":"3.50.1"},"reference-count":37,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,12,1]]},"abstract":"<jats:p>OBJECTIVE: We sought to determine the association of smoking status as a risk factor for reduced initiation and duration of breastfeeding.<\/jats:p><jats:p>METHODS: The Missouri Pregnancy Related Assessment and Monitoring System collected a stratified sample of new mothers in 2005. Surveys were mailed, with telephone follow-up, and completed within 2 to 12 months after delivery. Respondents were classified as nonsmokers, smokers who quit during pregnancy, light smokers (\u226410 cigarettes per day), or moderate\/heavy smokers (&amp;gt;10 cigarettes per day). Multivariable binomial regression and Cox proportional hazards models were used to assess breastfeeding initiation and duration according to smoking status.<\/jats:p><jats:p>RESULTS: Overall, 1789 women participated (weighted response rate: 61%). Approximately 74% of the women ever breastfed; 31% of the women ever smoked while pregnant. Compared with nonsmokers, the moderate\/heavy smokers and light smokers were less likely to initiate breastfeeding, after controlling for sociodemographic characteristics, the presence of other smokers in the household, alcohol use, mode of delivery, and infant hospitalization. Compared with nonsmokers, the moderate\/heavy smokers, light smokers, and smokers who quit during pregnancy were more likely to wean over time, controlling for the same covariates. There were no significant differences between nonsmokers and smokers regarding reasons for not initiating or ceasing breastfeeding.<\/jats:p><jats:p>CONCLUSIONS: Mothers who smoked initiated breastfeeding less often and weaned earlier than nonsmoking mothers. Incorporating knowledge of the association between smoking and breastfeeding into existing smoking-cessation and breastfeeding programs could provide opportunities to reduce perinatal exposure to tobacco smoke, improve interest in breastfeeding, and address other barriers to breastfeeding that smoking mothers may face.<\/jats:p>","DOI":"10.1542\/peds.2008-2711","type":"journal-article","created":{"date-parts":[[2009,11,17]],"date-time":"2009-11-17T01:34:38Z","timestamp":1258421678000},"page":"1603-1610","source":"Crossref","is-referenced-by-count":57,"title":["Association of Maternal Smoking Status With Breastfeeding Practices: Missouri, 2005"],"prefix":"10.1542","volume":"124","author":[{"given":"Thomas M.","family":"Weiser","sequence":"first","affiliation":[{"name":"Epidemic Intelligence Service"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Lin","sequence":"additional","affiliation":[{"name":"Missouri Department of Health and Senior Services, Jefferson City, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venkata","family":"Garikapaty","sequence":"additional","affiliation":[{"name":"Missouri Department of Health and Senior Services, Jefferson City, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W.","family":"Feyerharm","sequence":"additional","affiliation":[{"name":"Missouri Department of Health and Senior Services, Jefferson City, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana M.","family":"Bensyl","sequence":"additional","affiliation":[{"name":"Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bao-Ping","family":"Zhu","sequence":"additional","affiliation":[{"name":"Missouri Department of Health and Senior Services, Jefferson City, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2009,12,1]]},"reference":[{"key":"2021120905222014100_R1","doi-asserted-by":"crossref","unstructured":"Dorea JG. Maternal smoking and infant feeding: breastfeeding is better and safer. Matern Child Health J.\u20082007;11(3):287\u2013291","DOI":"10.1007\/s10995-006-0172-1"},{"key":"2021120905222014100_R2","doi-asserted-by":"crossref","unstructured":"Gartner LM, Morton J, Lawrence RA, et al. Breastfeeding and the use of human milk. Pediatrics.\u20082005;115(2):496\u2013506","DOI":"10.1542\/peds.2004-2491"},{"key":"2021120905222014100_R3","doi-asserted-by":"crossref","unstructured":"Horta BL, Victora CG, Menezes AM, Halpern R, Barros FC. Low birthweight, preterm births and intrauterine growth retardation in relation to maternal smoking. Paediatr Perinat Epidemiol.\u20081997;11(2):140\u2013151","DOI":"10.1046\/j.1365-3016.1997.d01-17.x"},{"key":"2021120905222014100_R4","doi-asserted-by":"crossref","unstructured":"Lambers DS, Clark KE. The maternal and fetal physiologic effects of nicotine. Semin Perinatol.\u20081996;20(2):115\u2013126","DOI":"10.1016\/S0146-0005(96)80079-6"},{"key":"2021120905222014100_R5","doi-asserted-by":"crossref","unstructured":"Fox SH, Koepsell TD, Daling JR. Birth weight and smoking during pregnancy: effect modification by maternal age. Am J Epidemiol.\u20081994;139(10):1008\u20131015","DOI":"10.1093\/oxfordjournals.aje.a116940"},{"key":"2021120905222014100_R6","doi-asserted-by":"crossref","unstructured":"Satcher D, Thompson TG, Koplan JP. Women and smoking: a report of the Surgeon General. Nicotine Tob Res.\u20082002;4(1):7\u201320","DOI":"10.1080\/14622200210135650"},{"key":"2021120905222014100_R7","doi-asserted-by":"crossref","unstructured":"Hopkinson JM, Schanler RJ, Fraley JK, Garza C. Milk production by mothers of premature infants: influence of cigarette smoking. Pediatrics.\u20081992;90(6):934\u2013938","DOI":"10.1542\/peds.90.6.934"},{"key":"2021120905222014100_R8","doi-asserted-by":"crossref","unstructured":"Vio F, Salazar G, Infante C. Smoking during pregnancy and lactation and its effects on breast-milk volume. Am J Clin Nutr.\u20081991;54(6):1011\u20131016","DOI":"10.1093\/ajcn\/54.6.1011"},{"key":"2021120905222014100_R9","doi-asserted-by":"crossref","unstructured":"Donath SM, Amir LH. The relationship between maternal smoking and breastfeeding duration after adjustment for maternal infant feeding intention. Acta Paediatr.\u20082004;93(11):1514\u20131518","DOI":"10.1111\/j.1651-2227.2004.tb02639.x"},{"key":"2021120905222014100_R10","doi-asserted-by":"crossref","unstructured":"Kiernan K, Pickett KE. Marital status disparities in maternal smoking during pregnancy, breastfeeding and maternal depression. Soc Sci Med.\u20082006;63(2):335\u2013346","DOI":"10.1016\/j.socscimed.2006.01.006"},{"key":"2021120905222014100_R11","doi-asserted-by":"crossref","unstructured":"Amir LH. Smoking status of breastfeeding women. Acta Paediatr.\u20081999;88(12):1412\u20131413","DOI":"10.1111\/j.1651-2227.1999.tb01063.x"},{"key":"2021120905222014100_R12","doi-asserted-by":"crossref","unstructured":"Alvik A, Haldorsen T, Lindemann R. Alcohol consumption, smoking and breastfeeding in the first six months after delivery. Acta Paediatr.\u20082006;95(6):686\u2013693","DOI":"10.1080\/08035250600649266"},{"key":"2021120905222014100_R13","doi-asserted-by":"crossref","unstructured":"Forster DA, McLachlan HL, Lumley J. Factors associated with breastfeeding at six months postpartum in a group of Australian women. Int Breastfeed J.\u20082006;1:18","DOI":"10.1186\/1746-4358-1-18"},{"key":"2021120905222014100_R14","doi-asserted-by":"crossref","unstructured":"Giglia R, Binns CW, Alfonso H. Maternal cigarette smoking and breastfeeding duration. Acta Paediatr.\u20082006;95(11):1370\u20131374","DOI":"10.1080\/08035250600771474"},{"key":"2021120905222014100_R15","doi-asserted-by":"crossref","unstructured":"Liu J, Rosenberg KD, Sandoval AP. Breastfeeding duration and perinatal cigarette smoking in a population-based cohort. Am J Public Health.\u20082006;96(2):309\u2013314","DOI":"10.2105\/AJPH.2004.060798"},{"key":"2021120905222014100_R16","doi-asserted-by":"crossref","unstructured":"Clifford TJ, Campbell MK, Speechley KN, Gorodzinsky F. Factors influencing full breastfeeding in a southwestern Ontario community: assessments at 1 week and at 6 months postpartum. J Hum Lact.\u20082006;22(3):292\u2013304","DOI":"10.1177\/0890334406290043"},{"key":"2021120905222014100_R17","unstructured":"Centers for Disease Control and Prevention. National Immunization Survey. Available at: www.cdc.gov\/vaccines\/stats-surv\/imz-coverage.htm. Accessed June 20, 2008"},{"key":"2021120905222014100_R18","unstructured":"Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S. Births: final data for 2004. Natl Vital Stat Rep.\u20082006;55(1):1\u2013101. Available at: www.cdc.gov\/nchs\/data\/nvsr\/nvsr55\/nvsr55_01.pdf. Accessed June 20, 2008"},{"key":"2021120905222014100_R19","unstructured":"Missouri Department of Health and Senior Services. Missouri vital statistics, 2004. Available at: www.dhss.mo.gov\/VitalStatistics\/MVS04\/Preface.pdf. Accessed June 20, 2008"},{"key":"2021120905222014100_R20","unstructured":"Beck LF, Morrow B, Lipscomb LE, et al. Prevalence of selected maternal behaviors and experiences, Pregnancy Risk Assessment Monitoring System (PRAMS), 1999. MMWR Surveill Summ.\u20082002;51(2):1\u201327"},{"key":"2021120905222014100_R21","doi-asserted-by":"crossref","unstructured":"Carmichael SL, Ahluwalia IB. Correlates of postpartum smoking relapse: results from the Pregnancy Risk Assessment Monitoring System (PRAMS). Am J Prev Med.\u20082000;19(3):193\u2013196","DOI":"10.1016\/S0749-3797(00)00198-7"},{"key":"2021120905222014100_R22","doi-asserted-by":"crossref","unstructured":"Kotelchuck M. Pregnancy Risk Assessment Monitoring System (PRAMS): possible new roles for a national MCH data system. Public Health Rep.\u20082006;121(1):6\u201310","DOI":"10.1177\/003335490612100105"},{"key":"2021120905222014100_R23","doi-asserted-by":"crossref","unstructured":"Horta BL, Victora CG, Menezes AM, Barros FC. Environmental tobacco smoke and breastfeeding duration. Am J Epidemiol.\u20081997;146(2):128\u2013133","DOI":"10.1093\/oxfordjournals.aje.a009243"},{"key":"2021120905222014100_R24","doi-asserted-by":"crossref","unstructured":"Chen Y, Dales R, Krewski D, Breithaupt K. Increased effects of smoking and obesity on asthma among female Canadians: the National Population Health Survey, 1994\u20131995. Am J Epidemiol.\u20081999;150(3):255\u2013262","DOI":"10.1093\/oxfordjournals.aje.a009996"},{"key":"2021120905222014100_R25","unstructured":"Hosmer DW Jr, Lemeshow S. Applied Survival Analysis: Regression Modeling of Time to Event Data. New York, NY: John Wiley & Sons, Inc; 1999"},{"key":"2021120905222014100_R26","doi-asserted-by":"crossref","unstructured":"Severson HH, Andrews JA, Lichtenstein E, Wall M, Akers L. Reducing maternal smoking and relapse: long-term evaluation of a pediatric intervention. Prev Med.\u20081997;26(1):120\u2013130","DOI":"10.1006\/pmed.1996.9983"},{"key":"2021120905222014100_R27","doi-asserted-by":"crossref","unstructured":"Di Napoli A, Di Lallo D, Pezzotti P, Forastiere F, Porta D. Effects of parental smoking and level of education on initiation and duration of breastfeeding. Acta Paediatr.\u20082006;95(6):678\u2013685","DOI":"10.1080\/08035250600580578"},{"key":"2021120905222014100_R28","doi-asserted-by":"crossref","unstructured":"Ludvigsson JF, Ludvigsson J. Socio-economic determinants, maternal smoking and coffee consumption, and exclusive breastfeeding in 10205 children. Acta Paediatr.\u20082005;94(9):1310\u20131319","DOI":"10.1111\/j.1651-2227.2005.tb02093.x"},{"key":"2021120905222014100_R29","unstructured":"Centers for Disease Control and Prevention. Racial and socioeconomic disparities in breastfeeding: United States, 2004. MMWR Morb Mortal Wkly Rep.\u20082006;55(12):335\u2013339"},{"key":"2021120905222014100_R30","doi-asserted-by":"crossref","unstructured":"Gudnadottir M, Gunnarsson BS, Thorsdottir I. Effects of sociodemographic factors on adherence to breastfeeding and other important infant dietary recommendations. Acta Paediatr.\u20082006;95(4):419\u2013424","DOI":"10.1080\/0803520500434769"},{"key":"2021120905222014100_R31","doi-asserted-by":"crossref","unstructured":"Kelly YJ, Watt RG. Breast-feeding initiation and exclusive duration at 6 months by social class: results from the Millennium Cohort Study. Public Health Nutr.\u20082005;8(4):417\u2013421","DOI":"10.1079\/PHN2004702"},{"key":"2021120905222014100_R32","doi-asserted-by":"crossref","unstructured":"Andersen AN, Lund-Andersen C, Larsen JF, et al. Suppressed prolactin but normal neurophysin levels in cigarette smoking breast-feeding women. Clin Endocrinol (Oxf).\u20081982;17(4):363\u2013368","DOI":"10.1111\/j.1365-2265.1982.tb01601.x"},{"key":"2021120905222014100_R33","doi-asserted-by":"crossref","unstructured":"Edwards N, Sims-Jones N. Smoking and smoking relapse during pregnancy and postpartum: results of a qualitative study. Birth.\u20081998;25(2):94\u2013100","DOI":"10.1046\/j.1523-536x.1998.00094.x"},{"key":"2021120905222014100_R34","doi-asserted-by":"crossref","unstructured":"Scott JA, Binns CW, Oddy WH, Graham KI. Predictors of breastfeeding duration: evidence from a cohort study. Pediatrics.\u20082006;117(4). Available at: www.pediatrics.org\/cgi\/content\/full\/117\/4\/e646","DOI":"10.1542\/peds.2005-1991"},{"key":"2021120905222014100_R35","doi-asserted-by":"crossref","unstructured":"Henderson JJ, Evans SF, Straton JA, Priest SR, Hagan R. Impact of postnatal depression on breastfeeding duration. Birth.\u20082003;30(3):175\u2013180","DOI":"10.1046\/j.1523-536X.2003.00242.x"},{"key":"2021120905222014100_R36","doi-asserted-by":"crossref","unstructured":"Dietz PM, Adams MM, Kendrick JS, Mathis MP. Completeness of ascertainment of prenatal smoking using birth certificates and confidential questionnaires: variations by maternal attributes and infant birth weight. PRAMS Working Group. Pregnancy Risk Assessment Monitoring System. Am J Epidemiol.\u20081998;148(11):1048\u20131054","DOI":"10.1093\/oxfordjournals.aje.a009581"},{"key":"2021120905222014100_R37","doi-asserted-by":"crossref","unstructured":"Forster D, McLachlan H, Lumley J, Beanland C, Waldenstrom U, Amir L. Two mid-pregnancy interventions to increase the initiation and duration of breastfeeding: a randomized controlled trial. Birth.\u20082004;31(3):176\u2013182","DOI":"10.1111\/j.0730-7659.2004.00302.x"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/124\/6\/1603\/1022323\/zpe01209001603.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/124\/6\/1603\/1022323\/zpe01209001603.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T15:35:20Z","timestamp":1685201720000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/124\/6\/1603\/72215\/Association-of-Maternal-Smoking-Status-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,12,1]]},"references-count":37,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2009,12,1]]},"published-print":{"date-parts":[[2009,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2008-2711","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,12,1]]}}}