Postpartum Changes in Mood and Smoking-Related Symptomatology: An Ecological Momentary Assessment Investigation

Introduction: Postpartum smoking relapse is a highly prevalent public health problem. Mood and breast feeding are significantly associated with smoking relapse, although less is known about the temporality of these relationships. Therefore, this study utilized ecological momentary assessments (EMA) to prospectively examine changes in mood and smoking-related symptomatology in relationship to three events-childbirth, termination of breast feeding, and smoking relapse. We expected all three events to significantly alter mood and smoking-related symptomatology. Methods: We enrolled a sample of pregnant women who had recently quit smoking and intended to remain quit during the postpartum. Participants were randomized to active/placebo progesterone to prevent postpartum relapse. Participants also completed daily EMA to collect data mood and smoking-related symptomatology as well as our three events of interest. Results: Participants (n = 46) were, on average, 26.5 +/- 0.8 years old and, prior to pregnancy, smoked 10.1 +/- 0.7 cigarettes/day. We noted a number of significant within-and between-subject relationships. For example, participants reported a 24% decline in negative affect after childbirth (p = .0016). Among those who relapsed to smoking (n = 23), participants randomized to placebo had a significant increase in cigarette craving after relapse (beta = 1.06, 95% confidence interval [CI] = 0.62 to 1.49, p value = .0003), whereas participants randomized to active progesterone did not (beta = 0.63, 95% CI = -0.35 to 1.62, p value = .1824). Conclusions: These observations suggest that mood and smoking-related symptomatology are influenced by childbirth, breast feeding, smoking relapse, and use of exogenous progesterone. Future research should explore how these observations may inform novel postpartum smoking relapse-prevention interventions.National Institutes of Health [R21DA034840]; Building Interdisciplinary Research Careers in Women's Health Grant from the Eunice Kennedy Shriver National Institutes of Child Health and Human Development (NICHD) [K12HD055887]; Office of Research on Women's Health; National Institute on Aging, NIH; Research Services, Department of Family Medicine and Community Health, Medical School, University of Minnesota; National Center for Advancing Translational Sciences of the National Institutes of Health [UL1TR000114]12 month embargo; published online: 01 June 2017This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu