The association between social stressors and home smoking rules among women with infants in the United States

Objectives. We examined the role of social stressors on home-smoking rules (HSRs) among women with infants in the United States, with attention on the moderating role of smoking status and depression.

Methods. We analyzed data for 118 062 women with recent births in the United States who participated in the Pregnancy Risk Assessment Monitoring System (2004-2010), which is a population-based surveillance data set. We fit multinomial logistic models to predict the odds of partial or no HSRs by a cumulative index of prenatal social stressors.

Results. Compared with those with no stressors, mothers with high levels of social stressors had 2.5 times higher odds of partial or no HSRs. Smokers in the 1-2, 3-5, and ≥ 6 stressor categories were 9.0%, 9.6%, and 10.8% more likely to have partial or no HSRs, respectively. Under the highest levels of stress (≥ 6), nonsmokers were almost as likely as smokers to have partial or no HSRs. In addition, the effects of stress on HSRs were more pronounced for nonsmoker, nondepressed mothers.

Conclusions. Increases in social stressors represented an important risk factor for partial or no HSRs and might have potential negative implications for infants.