# Analysis of pooled cross-sectional study data on smoking among pregnant and nursing mothers after a disaster: Pregnancy and birth survey of the Fukushima health management survey

## TL;DR

This study examines smoking behaviors among mothers in Fukushima after a disaster, identifying factors linked to relapse or continued smoking post-childbirth.

## Contribution

The study provides insights into post-disaster smoking cessation challenges and highlights the role of mental health and disaster-related factors.

## Key findings

- Young age, multiparity, and depression tendency were associated with relapse after childbirth.
- Evacuation status and radiation risk perception were linked to continued smoking.
- Disaster-affected mothers require multifaceted support for smoking cessation and health promotion.

## Abstract

Japan is one of the countries most affected by both the global tobacco epidemic and disasters, which are often interrelated. This study aimed to analyze factors related to continuation of smoking or relapse after childbirth among women who smoked before pregnancy and inform approaches to help them continue smoking cessation in a post-disaster setting, such as that after the Fukushima nuclear accident.

We conducted a pooled analysis of secondary data collection from Fukushima prefecture-wide cross-sectional self-administered questionnaire-based surveys. Participants were recruited from women given a Maternal and Child Health Handbook by their city of residence in Fukushima Prefecture from 2013 to 2016. A total of 17211 responses to the Pregnancy and Birth Survey were analyzed. Women who smoked before pregnancy were divided according to smoking status during pregnancy and after childbirth, and then compared with those who did not smoke before pregnancy in terms of evacuation status, radiation risk perception, age, parity, subjective health, and depression tendency.

A total of 16417 respondents did not smoke before pregnancy. Among those who smoked before pregnancy, 634 quit smoking during pregnancy and maintained cessation after childbirth, 182 quit smoking during pregnancy but relapsed afterward, 195 smoked during pregnancy but quit after childbirth, and 582 continued smoking during and after pregnancy. Age ≤24 years (AOR=2.36), multiparity (AOR=1.61), and depression tendency (AOR=1.85) were associated with relapse. Current evacuation status (AOR=1.65), radiation risk perception (AOR=0.55), age ≤24 years (AOR=2.19), multiparity (AOR=1.90), disease history (AOR=1.33), and depression tendency (AOR=1.85) were associated with continuation of smoking.

Previous smokers who continue smoking or relapse after childbirth need support that addresses complex underlying factors, including mental health. Continuation of smoking was particularly associated with disaster-related factors, suggesting that disaster-affected mothers need multifaceted support for health promotion.