Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention
Introduction Among women at risk for alcohol-exposed pregnancies (AEP), smoking tobacco may be associated with increased severity of alcohol use, and risk for tobacco-exposed and other substance-exposed pregnancies (TEPs/SEPs). Our secondary data analysis of the ‘CHOICES Plus’ intervention trial exp...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Publishing
2024-07-01
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| Series: | Tobacco Induced Diseases |
| Subjects: | |
| Online Access: | https://www.tobaccoinduceddiseases.org/Increased-risk-for-alcohol-and-other-substance-exposed-pregnancies-among-women-who,191107,0,2.html |
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| Summary: | Introduction
Among women at risk for alcohol-exposed pregnancies (AEP), smoking
tobacco may be associated with increased severity of alcohol use, and risk for
tobacco-exposed and other substance-exposed pregnancies (TEPs/SEPs). Our
secondary data analysis of the ‘CHOICES Plus’ intervention trial explored AEP
and SEP risk by smoking status.
Material and Methods
Eligible women (N=261) were recruited from 12 primary care clinics in
a public healthcare system, not pregnant, aged 18–44 years, drinking >3 drinks/
day or >7 drinks/week, sexually active, and not using effective contraception.
We compared women who did and did not smoke tobacco on alcohol and drug
severity, and psychological distress (e.g. anxiety) at baseline.
Results
Participants were primarily Hispanic (47.1%) or non-Hispanic Black
(41.8%) and reported incomes <$20000/year (69.3%). Tobacco smoking
prevalence was 45.2%. Compared to non-smokers, those who smoked drank
more days/week (mean=3.3, SD=2.0 vs mean=2.7, SD=1.8, p<0.01), had higher
alcohol use disorders identification test (AUDIT) scores (mean=12.1, SD=7.6 vs
mean=9.8, SD=7.1, p<0.05), were more likely to report current drug use (66.1%
vs 48.3%, p<0.01), and had a greater number of (lifetime) drugs used (mean=3.0,
SD=2.0 vs mean=2.0, SD=1.5 days, p<0.0001). Also, those who smoked reported
greater levels of anxiety (mean=5.9, SD=5.6 vs mean=4.5, SD=4.9, p<0.05), lower
confidence to not drink (mean=2.8, SD=0.8 vs mean=3.1, SD=1.0, p<0.01), lower
confidence to reduce risky drinking (mean=6.3, SD=3.1 vs mean=7.3, SD=2.8,
p<0.0001), greater drinking temptations (mean=3.0, SD=0.9 vs mean=2.6,
SD=0.9, p<0.01), and, yet greater readiness to reduce alcohol use (mean=6.2,
SD=3.0 vs mean=5.2, SD=3.0, p<0.05).
Conclusions
Women who drink and smoke may have the highest AEP, TEP, and
other SEP risk. Primary care providers should screen for alcohol and tobacco
co-use and provide brief intervention and/or treatment referral.
CLINICAL TRIAL REGISTRATION
The study was registered on the official website of ClinicalTrials.gov
IDENTIFIER
ID NCT01032772 |
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| ISSN: | 1617-9625 |