Tobacco Smoke Use and Exposure Are Linked with Breastfeeding Psychosocial Factors and Behaviors

Authors

  • Patricia Markham Risica "Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, Rhode Island", "Department of Epidemiology, Brown School of Public Health, Providence Rhode Island" & "Center for Health Promotion and Health Equity, Brown School of Public Health, Providence Rhode Island"
  • Anna Alikhani Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, Rhode Island https://orcid.org/0000-0003-0620-0866
  • Melanie Morales Aquino Brown University, Providence, Rhode Island
  • Samantha Buyungo Brown University, Providence, Rhode Island
  • Paola Solano Brown University, Providence, Rhode Island
  • Selena Evora Center for Health Promotion and Health Equity, Brown School of Public Health, Providence Rhode Island
  • Tayla von Ash Center for Health Promotion and Health Equity, Brown School of Public Health, Providence Rhode Island

DOI:

https://doi.org/10.12974/2311-8687.2025.13.03

Keywords:

Tobacco, Smoke, ETS, Exposure, Breastfeeding

Abstract

Background and Objective: To describe the intersection of tobacco smoke exposure with breastfeeding psychosocial predictors and practice.

Methods: This is a secondary analysis of the Baby’s Breath study data among a free-living people from southeastern New England. Participants were 843 pregnant people who use (38%), recently quit (23%) or are exposed to (39%) tobacco smoke, who intended (77%) to breastfeed, and who were 55% married, 53% primiparous, 56% unemployed, 41% non-Hispanic White, 27% Hispanic, 13% non-Hispanic Black, and 28% <21, 39% 21-25 or 33%>25 years old. Main outcome measures were self-reported breastfeeding intentions and predictors at 16- and 32-weeks gestation, breastfeeding initiation and continuation at 3 and 6 months postpartum, and tobacco use and exposure at all timepoints. Chi-square and regression models assessed breastfeeding and smoking status and associations between psychosocial scores with breastfeeding intention and smoking status.

Results: Breastfeeding variables differed by smoking exposure. Psychosocial scores were associated with breastfeeding intention. Knowledge, self-efficacy, and social support scores were associated with tobacco smoke exposure during pregnancy.

Conclusions: Breastfeeding intention, practice, and associated knowledge, self-efficacy, and social support are associated with tobacco use and exposure. Tobacco smoke avoidance messaging and breastfeeding support addressing common antecedents will likely lead to less smoke-exposed, more successfully breastfed babies with better health outcomes.

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2025-05-20

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Risica, P. M. ., Alikhani, A., Morales Aquino, M., Buyungo, S., Solano, P., Evora, S., & Ash, T. von . (2025). Tobacco Smoke Use and Exposure Are Linked with Breastfeeding Psychosocial Factors and Behaviors. International Journal of Pediatrics and Child Health, 13, 15–25. https://doi.org/10.12974/2311-8687.2025.13.03

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