Perceptions of family functioning impact smoking during pregnancy

Abstract

Background

Although socio-environmental factors are known to contribute to the maintenance of smoking behavior, few studies have examined the impact of family functioning on smoking during pregnancy.

Objective

The current study examined the relationship between perceptions of family functioning and smoking during pregnancy.

Methods

Pregnant women (N = 345, 59% ethnic/racial minority) completed the Family Assessment Device, a gold-standard assessment examining perceptions of family functioning in seven domains. Multinomial logistic regressions analyzed associations between clinically determined suboptimal levels of family functioning by domain and smoking status during pregnancy (smoking, ≥28 continuous days quit, nonsmoking), with stratified analyses exploring ethnic/racial differences (non-Hispanic/White vs. racial/ethnic minority).

Results

Participants who reported suboptimal levels of family functioning in domains of Affective Involvement, Affective Responsiveness, Behavioral Control, and Roles were significantly more likely to have been smoking than nonsmoking during pregnancy. Stratified analyses revealed differing effects by ethnic/racial identity, with perceptions of Roles remaining the only significant effect on smoking outcomes for both groups. No significant effects were found regarding the impact of family functioning on whether participants were smoking vs. quit during pregnancy.

Conclusions

Suboptimal family functioning may contribute to smoking during pregnancy, but effects may differ based on domain of family functioning and by ethnic/racial identity.

Keywords:

• Smoking
• pregnancy
• family functioning
• ethnic/racial differences

Acknowledgement

We are grateful to the pregnant women who contributed to this study, and to the Maternal-Infant Studies Laboratory staff for their assistance with data collection and data management.

Authors’ contributions

Nancy C. Jao: Conceptualization, Formal analysis, Methodology, Visualization, Writing – original draft. Marcia M. Tan: Conceptualization, Writing – original draft. Ariana Albanese: Conceptualization, Writing – original draft. Jacinda Lee: Writing – original draft. Laura R. Stroud: Funding acquisition, Investigation, Project administration, Resources, Supervision, Writing – original draft.

Disclosure statement

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the article. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH. NIH had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Authors have no other potential conflicts of interest.

Additional information

Funding

This research was funded by National Institute on Drug Abuse (5R01DA019558, 4RO1DA031188, 5R01DA036999, 5R01DA045492, 5R01DA044504, 1R01DA056787 to LRS). NCJ was supported by the National Heart, Lung, and Blood Institute (K01HL164670), and LRS was also supported by the National Institute of Environmental Health Sciences (2U24028507 to LRS) and the National Institute of General Medical Sciences (1P20GM139767 to LRS).