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女性在怀孕前后吸烟的生命历程影响。

Lifecourse influences on women's smoking before, during and after pregnancy.

机构信息

University of York, Department of Health Sciences, Area 2, Seebohm Rowntree Building Dept., York YO10 5DD, United Kingdom.

出版信息

Soc Sci Med. 2010 Feb;70(4):582-7. doi: 10.1016/j.socscimed.2009.10.041. Epub 2009 Nov 24.

Abstract

The concept of the socioeconomic lifecourse is increasingly informing understanding of the social patterning of cigarette smoking. We investigated lifecourse influences on (i) women's smoking status (smoker/non-smoker) before pregnancy and (ii) quitting in pregnancy in the UK Millennium Cohort study. Our analyses included conventional measures of the socioeconomic lifecourse (woman's childhood circumstances, education, current socioeconomic circumstances) and measures of her domestic lifecourse (age of becoming a mother, current cohabitation status), as well as parity (first/subsequent child). In analyses of quitting, we also included pre-pregnancy cigarette consumption. Our study underlined, firstly, the importance of lifecourse disadvantage. Those experiencing greater disadvantage with respect to their childhood circumstances, education and current circumstances were at greater risk of being a smoker before pregnancy. A disadvantaged domestic lifecourse - earlier entry into motherhood and lone motherhood-further increased the risk. Poorer childhood circumstances, educational disadvantage, poorer current circumstances and early motherhood also significantly increased the odds of quitting in pregnancy. Secondly, parity was a major predictor of smoking behaviour. First-time mothers had higher odds both of smoking before pregnancy and quitting in pregnancy. The effects of parity were independent of women's lifecourse. Our study supports tobacco control policies which recognise and address inequalities across the lifecourse. However, our study suggests that the dye is not irrevocably cast by social disadvantage: first pregnancy uniformly increases the chances of quitting. Interventions which help smokers having their first baby to quit have an important part to play in promoting maternal and child health.

摘要

社会经济生活历程的概念越来越多地为人们理解吸烟的社会模式提供了信息。我们在英国千禧年队列研究中调查了生活历程对(i)女性怀孕前的吸烟状况(吸烟者/非吸烟者)和(ii)怀孕期间戒烟的影响。我们的分析包括社会经济生活历程的常规指标(女性的童年环境、教育、当前社会经济状况)和家庭生活历程的指标(成为母亲的年龄、当前同居状况),以及生育次数(第一胎/后续子女)。在戒烟分析中,我们还包括了怀孕前的香烟消费。我们的研究首先强调了生活历程劣势的重要性。那些在童年环境、教育和当前环境方面经历更多劣势的人,在怀孕前吸烟的风险更高。不利的家庭生活历程——更早进入母亲身份和单身母亲身份——进一步增加了这种风险。较差的童年环境、教育劣势、较差的当前环境和早期母亲身份也显著增加了怀孕期间戒烟的几率。其次,生育次数是吸烟行为的主要预测因素。初产妇在怀孕前吸烟和怀孕期间戒烟的几率都更高。生育次数的影响独立于女性的生活历程。我们的研究支持认识到生活历程中存在不平等并加以解决的烟草控制政策。然而,我们的研究表明,社会劣势并不是不可逆转的:第一次怀孕会均匀地增加戒烟的机会。帮助吸烟的初产妇戒烟的干预措施在促进母婴健康方面发挥着重要作用。

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