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: Thomas F. Northrup, Angela L. Stotts, Stephen M. Fischer, Kirk L. von Sternberg, Mary M. Velasquez
Format: Article
Language:English
Published: European Publishing 2024-07-01
Series:Tobacco Induced Diseases
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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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author Thomas F. Northrup
Angela L. Stotts
Stephen M. Fischer
Kirk L. von Sternberg
Mary M. Velasquez
author_facet Thomas F. Northrup
Angela L. Stotts
Stephen M. Fischer
Kirk L. von Sternberg
Mary M. Velasquez
author_sort Thomas F. Northrup
collection DOAJ
description 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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spelling doaj-art-1f22d7e9316040b2bf554f0377d199f52025-01-24T15:27:00ZengEuropean PublishingTobacco Induced Diseases1617-96252024-07-0122July1510.18332/tid/191107191107Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based interventionThomas F. Northrup0https://orcid.org/0000-0002-3275-3168Angela L. Stotts1Stephen M. Fischer2Kirk L. von Sternberg3Mary M. Velasquez4Department of Family and Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, United StatesDepartment of Family and Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, United StatesDepartment of Family and Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, United StatesHealth Behavior Research and Training Institute, University of Texas at Austin, Austin, United StatesHealth Behavior Research and Training Institute, University of Texas at Austin, Austin, United StatesIntroduction 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 NCT01032772https://www.tobaccoinduceddiseases.org/Increased-risk-for-alcohol-and-other-substance-exposed-pregnancies-among-women-who,191107,0,2.htmlsubstance-exposed pregnancypreconceptionalcohol-exposed pregnancytobacco-exposed pregnancy
spellingShingle Thomas F. Northrup
Angela L. Stotts
Stephen M. Fischer
Kirk L. von Sternberg
Mary M. Velasquez
Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention
Tobacco Induced Diseases
substance-exposed pregnancy
preconception
alcohol-exposed pregnancy
tobacco-exposed pregnancy
title Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention
title_full Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention
title_fullStr Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention
title_full_unstemmed Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention
title_short Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention
title_sort increased risk for alcohol and other substance exposed pregnancies among women who smoke tobacco a secondary analysis of a primary care based intervention
topic substance-exposed pregnancy
preconception
alcohol-exposed pregnancy
tobacco-exposed pregnancy
url https://www.tobaccoinduceddiseases.org/Increased-risk-for-alcohol-and-other-substance-exposed-pregnancies-among-women-who,191107,0,2.html
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