Purpose: This study aimed to compare rates of adolescent pregnancy among African-American adolescents who began smoking as adolescents with those who did not.
Methods: Cross-sectional data on 1042 primiparous African-American women enrolled in a randomized clinical trial of nurse home visitation were examined. The independent variable, adolescent smoking, was defined as a report of smoking before the age of 18 years. The outcome variable was adolescent pregnancy, defined as first pregnancy before the age of 18 years. Logistic regression was used to control for potential confounders.
Results: After adjustments for drug use, use of contraception, frequency of coitus, and sexually transmitted diseases, women who smoked during adolescence had a 50% lower risk of becoming pregnant as an adolescent [odds ratio of 0.46 (95% confidence interval [CI] 0.27-0.76)]. When time to first pregnancy was examined as a continuous variable, adolescent smoking was associated with a delay in pregnancy of 22.6 months (95% CI 16.8-29.2).
Conclusions: Teen smoking appears to be associated with a significantly lower rate of adolescent pregnancy among African-Americans. Although the nature of this relationship is unclear, this finding suggests the need for linkage between smoking prevention and adolescent pregnancy prevention.
PIP: Adolescent smoking has been linked to adolescent risk-taking behavior, including earlier and unprotected sexual activity, and drug use. The authors compared rates of adolescent pregnancy among Black adolescents who began smoking as adolescents against the rates of those who did not. Adolescent smoking was defined as a report of smoking before reaching age 18 years, while adolescent pregnancy was defined as pregnancy to women under age 18. Cross-sectional data on 1042 primiparous Black women enrolled in a randomized clinical trial of nurse home visitation were examined. Women in the study sample were aged 12-33 years, of mean age 17.9 years, at enrollment, 99% were unmarried, 85% were below 100% of the federal poverty level, and they had 10.2 mean years of education. After adjusting for drug use, contraceptive use, frequency of coitus, and infection with sexually transmitted diseases, women who smoked cigarettes during adolescence had a 50% lower risk of becoming pregnant as adolescents. When time to first pregnancy was examined as a continuous variable, adolescent smoking was associated with a delay in pregnancy of 22.6 months. These findings are consistent with previously reported findings based mainly upon adult White women. The nature of this relationship is unclear, but the data alone cannot establish causation between adolescent smoking and delay in pregnancy.