Changes in Maternal Cigarette Smoking Among Pregnant WIC Participants in Rhode Island

Objectives: To describe the relationship between the timing of entry into the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) among pregnant women in Rhode Island (RI) and changes in maternal cigarette smoking (MCS) during pregnancy.

Methods: MCS data gathered by WIC were analyzed for pregnant women who self-identified as smokers at the onset of pregnancy between the years 2001-2005. Bivariate and multivariate analyses were performed to examine the relationship between timing of WICentry and both increased and decreased/quit MCS during pregnancy.

Results: Self-reports from smokers indicated that 9.5% quit smoking, 24.6% decreased MCS, 26.8% experienced no change, 33.5% increased MCS, and 5.6% attempted to quit MCS but failed during pregnancy. The adjusted odds ratio for smokers with 1st trimester WIC entry and increased MCS was 0.64 (95% CI 0.52, 0.79). Among smokers with 1st trimester PNC entry, the adjusted odds ratio for smokers with 1st trimester WIC entry and decreased/quit MCS was 1.51 (95% CI 1.17, 1.96).

Conclusions: Early WIC entry appears to be associated with improvements in MCS. Participants who entered WIC in the first trimester of pregnancy were less likely to increase smoking during pregnancy, and if they also had first trimester prenatal care, were more likely to decrease/quit smoking compared to those who entered WIC later. Programs that increase the rates of first trimester WIC entry may contribute to lower rates of MCS in the WIC population.