Social Support and Smoking during Pregnancy.

Background: Smoking during pregnancy and a lack of social support have been identified as independent risk factors for poor birth outcomes. However, the influence of social support on smoking during pregnancy remains under-investigated. This study examined the association between domains of social support and smoking during pregnancy.

Methods: Pregnant women during their first trimester, attending three inner-city clinics were surveyed using self-administered questionnaires (N=227). Social support was measured using the Interpersonal Support Evaluation List (ISEL). Three domains of social support (tangible, appraisal, and belonging) were examined. Multiple logistic regressions were conducted; Odds Ratios (OR) and 95% confidence intervals were calculated.

Results: Per unit increase in the total composite social support scale, there was a 6% increased odds of smoking during pregnancy. There was a statistically significant interaction between race and social support. While the tangible support (OR=1.15; 95% CI: 1.03, 1.27) and appraisal (OR=1.17; 95% CI: 1.05, 1.31) domains were significantly associated with smoking among African American women, only the belonging support domain was significantly associated with smoking during pregnancy among Caucasian women (OR=1.20; 95% CI: 1.02, 1.40).

Conclusions: This study provided evidence that racial differences may exist in the way social support influences smoking during pregnancy. Future studies are needed to understand these racial differences and assist in the design of interventions. Considering the importance of social support, strategies for smoking cessation intervention should consider racial difference.