Increased risk for alcohol- and other substance-exposed pregnancies among women who smoke tobacco: A secondary analysis of a primary care-based intervention.

Autor: Northrup TF; Department of Family and Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, United States., Stotts AL; Department of Family and Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, United States.; Department of Psychiatry and Behavioral Sciences, UTHealth Houston, McGovern Medical School, Houston, United States., Fischer SM; Department of Family and Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, United States., von Sternberg KL; Health Behavior Research and Training Institute, University of Texas at Austin, Austin, United States., Velasquez MM; Health Behavior Research and Training Institute, University of Texas at Austin, Austin, United States.
Jazyk: angličtina
Zdroj: Tobacco induced diseases [Tob Induc Dis] 2024 Jul 26; Vol. 22. Date of Electronic Publication: 2024 Jul 26 (Print Publication: 2024).
DOI: 10.18332/tid/191107
Abstrakt: Introduction: Among women at risk for alcohol-exposed pregnancies (AEP), smoking tobacco may be associated with increased severity of alcohol use, and risk for tobacco-exposed and other substance-exposed pregnancies (TEPs/SEPs). Our secondary data analysis of the 'CHOICES Plus' intervention trial explored AEP and SEP risk by smoking status.
Methods: Eligible women (N=261) were recruited from 12 primary care clinics in a public healthcare system, not pregnant, aged 18-44 years, drinking >3 drinks/day or >7 drinks/week, sexually active, and not using effective contraception. We compared women who did and did not smoke tobacco on alcohol and drug severity, and psychological distress (e.g. anxiety) at baseline.
Results: Participants were primarily Hispanic (47.1%) or non-Hispanic Black (41.8%) and reported incomes <$20000/year (69.3%). Tobacco smoking prevalence was 45.2%. Compared to non-smokers, those who smoked drank more days/week (mean=3.3, SD=2.0 vs mean=2.7, SD=1.8, p<0.01), had higher alcohol use disorders identification test (AUDIT) scores (mean=12.1, SD=7.6 vs mean=9.8, SD=7.1, p<0.05), were more likely to report current drug use (66.1% vs 48.3%, p<0.01), and had a greater number of (lifetime) drugs used (mean=3.0, SD=2.0 vs mean=2.0, SD=1.5 days, p<0.0001). Also, those who smoked reported greater levels of anxiety (mean=5.9, SD=5.6 vs mean=4.5, SD=4.9, p<0.05), lower confidence to not drink (mean=2.8, SD=0.8 vs mean=3.1, SD=1.0, p<0.01), lower confidence to reduce risky drinking (mean=6.3, SD=3.1 vs mean=7.3, SD=2.8, p<0.0001), greater drinking temptations (mean=3.0, SD=0.9 vs mean=2.6, SD=0.9, p<0.01), and, yet greater readiness to reduce alcohol use (mean=6.2, SD=3.0 vs mean=5.2, SD=3.0, p<0.05).
Conclusions: Women who drink and smoke may have the highest AEP, TEP, and other SEP risk. Primary care providers should screen for alcohol and tobacco co-use and provide brief intervention and/or treatment referral.
Clinical Trial Registration: The study was registered on the official website of ClinicalTrials.gov.
Identifier: ID NCT01032772.
Competing Interests: The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. T.F. Northrup reports that since the initial planning of the work, support for the article processing charges was provided by the University of Texas Health Science Center at Houston, Department of Family & Community Medicine. K.L. von Sternberg and M.M. Velasquez report that since the initial planning of the work the original trial from which the data were taken was funded by the CDC (1U84DD000438).
(© 2024 Northrup T.F. et al.)
Databáze: MEDLINE
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