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Marijuana Use Before Pregnancy Made Hispanic Women Less Likely to Quit Smoking When They Became Pregnant

Cross SectionalModerate evidence
The takeaway

Among 351 Hispanic women who smoked before pregnancy, those with pre-pregnancy marijuana use were 23-49% less likely to quit smoking at pregnancy onset.

Read this if you work with pregnant women and want to understand barriers to smoking cessation.

Marijuana-using women were 23-49% less likely to quit smoking when they became pregnant

What the researchers found

Researchers examined factors associated with quitting smoking at pregnancy onset in 351 Hispanic (predominantly Puerto Rican) women from Massachusetts.

45% of women quit smoking when they learned they were pregnant.

Women who used marijuana before pregnancy were significantly less likely to quit smoking (23-49% less likely in multivariate analyses). Other factors associated with continued smoking included high stress, higher pre-pregnancy cigarette consumption (20+ per day), and having previous children.

Factors associated with quitting included being born outside the United States, having a family history of diabetes, and being non-Puerto Rican Hispanic.

Why it matters

Smoking during pregnancy is a major preventable risk factor. Understanding why some women do not quit when they become pregnant can help design targeted interventions, particularly for populations where marijuana co-use is a barrier.

The numbers in context

351 Hispanic women. 45% quit at pregnancy onset. Marijuana users were 23-49% less likely to quit. Heavy smokers (20+ cigarettes/day) had RR 0.44 for quitting vs light smokers.

How the study worked

Cross-sectional analysis of baseline data from a prospective cohort study (Latina Gestational Diabetes Mellitus Study). 351 Hispanic prenatal care patients who smoked in the year before pregnancy were analyzed. Logistic regression with backward elimination identified independent predictors of quitting.

What this study cannot tell us

Cross-sectional design at enrollment. Self-reported smoking and marijuana use. Predominantly Puerto Rican sample may not generalize to other populations. Marijuana use was measured as any use, without quantifying amount or frequency.

How to read the evidence

Cross-sectional analysis from a prospective cohort with appropriate multivariate controls. Single-population sample limits generalizability.

When this study was published

Published in 2010. Co-occurring marijuana and tobacco use during pregnancy has received increasing research attention since then.

The bigger picture

Co-use of marijuana and tobacco is increasingly common, and this study showed that marijuana use creates an additional barrier to smoking cessation during pregnancy, a period when quitting motivation is typically highest.

Questions still open

  • Does marijuana use causally prevent smoking cessation, or does it reflect higher overall risk-taking? Would addressing marijuana use in prenatal care improve smoking cessation rates? Do these patterns apply to other racial/ethnic groups?

Common questions

Why would marijuana use make it harder to quit smoking?
Several explanations are possible: marijuana and tobacco are often used together, marijuana users may have higher tolerance for substance use during pregnancy, or marijuana use may reflect broader patterns of risk behavior. The study found an association but could not determine the mechanism.
Did the women also continue using marijuana during pregnancy?
The study measured pre-pregnancy marijuana use as a predictor of smoking cessation. It did not specifically report marijuana use continuation during pregnancy.

Read the original research

Correlates of smoking cessation at pregnancy onset among Hispanic women in Massachusetts.

American journal of health promotion : AJHP, 25(2), 100-8

Citation

Haskins, Amy; Bertone-Johnson, Elizabeth; Pekow, Penelope; Carbone, Elena; Chasan-Taber, Lisa. (2010). Correlates of smoking cessation at pregnancy onset among Hispanic women in Massachusetts.. American journal of health promotion : AJHP, 25(2), 100-8. https://doi.org/10.4278/ajhp.090223-QUAN-77

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