Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA.
Breastfeed Med. 2022 Mar;17(3):226-232. doi: 10.1089/bfm.2021.0199. Epub 2022 Feb 14.
Pregnancy is a motivating factor to quit smoking, but many women relapse postpartum. The underlying mechanisms and the necessary duration of breastfeeding that provide long-term protection against postpartum smoking relapse are unknown. We aimed to examine (1) associations of smoking cessation with breastfeeding initiation and duration; (2) necessary breastfeeding duration to reduce or prevent risk of postpartum smoking relapse. In this cohort study, we recruited 55 mothers, either smoking or have quit smoking, who recently delivered their baby from the Greater Buffalo area, NY, USA. Quitters had a higher breastfeeding initiation rate (73.7% versus 30.8%; = 0.029) and breastfed longer ( < 0.024) than nonquitters. Mothers who never breastfed relapsed quicker than mothers who did ( = 0.039). There was a 28% reduction in smoking relapse at 12 months postpartum for every month longer of breastfeeding duration (confounder-adjusted hazard ratio, 0.72 [95% confidence interval, 0.55-0.94]; = 0.014). The estimated smoking relapse risk was 60.0% for nonbreastfeeding, 22.4% for 3 months of breastfeeding, 8.4% for 6 months of breastfeeding, and 1.2% for 12 months of breastfeeding. Smoking cessation was associated with increased breastfeeding initiation and duration. Smoking relapse risk decreased with longer breastfeeding duration, and 12 months of breastfeeding may help to prevent smoking relapse. An integrated intervention of maternal smoking cessation and breastfeeding promotion is promising to enhance both behaviors.
怀孕是戒烟的一个动机因素，但许多女性在产后会复吸。目前尚不清楚提供长期预防产后复吸的潜在机制和母乳喂养所需的持续时间。我们旨在检验：（1）戒烟与母乳喂养开始和持续时间的关联；（2）减少或预防产后复吸风险所需的母乳喂养持续时间。在这项队列研究中，我们招募了 55 位母亲，她们要么正在吸烟，要么已经戒烟，且最近在纽约布法罗地区分娩。与非戒烟者相比，戒烟者的母乳喂养开始率更高（73.7%与 30.8%；=0.029），且母乳喂养时间更长（ < 0.024）。从未母乳喂养的母亲比母乳喂养的母亲更快复吸（=0.039）。母乳喂养时间每增加一个月，产后 12 个月时的吸烟复吸风险降低 28%（经混杂因素调整后的危险比，0.72[95%置信区间，0.55-0.94]；=0.014）。非母乳喂养的吸烟复吸风险为 60.0%，母乳喂养 3 个月的风险为 22.4%，母乳喂养 6 个月的风险为 8.4%，母乳喂养 12 个月的风险为 1.2%。戒烟与母乳喂养开始和持续时间增加有关。随着母乳喂养时间的延长，吸烟复吸风险降低，12 个月的母乳喂养可能有助于预防吸烟复吸。将母亲戒烟和促进母乳喂养相结合的综合干预措施有望同时增强这两种行为。
