***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Aims To assess whether associations between maternal smoking during pregnancy and offspring smoking initiation  are due to intrauterine mechanisms . Design Comparison of associations of  maternal and partner smoking behaviour during pregnancy with  offspring smoking initiation using partner smoking as a negative control ( n = 6484 ) and a Mendelian r and omization analysis ( n = 1020 ) , using a genetic variant in the mothers as a proxy for smoking cessation during pregnancy . Setting A longitudinal birth cohort in South West Engl and . Participants Participants of the Avon Longitudinal Study of Parents and Children ( ALSPAC ) . Measurements  Smoking status during pregnancy  was self-reported by mother and partner in question naires administered at pregnancy . Latent classes of offspring smoking initiation ( non-smokers , experimenters , late-onset regular smokers and early-onset regular smokers ) were previously developed from question naires administered at 14–16 years . A genetic variant , rs1051730 , was genotyped in the mothers . Findings Both mother and partner smoking were similarly positively associated with offspring smoking initiation classes , even after adjustment for confounders . Odds ratios ( OR ) [ 95 % confidence interval ( CI ) ] for class membership compared with non-smokers were : experimenters : mother OR = 1.33 ( 95 % CI = 1.06 , 1.67 ) , partner OR = 1.28 ( 95 % CI = 1.06 , 1.55 ) , late-onset regular smokers : mother OR = 1.80 ( 95 % CI = 1.43 , 2.26 ) , partner OR = 1.86 ( 95 % CI = 1.52 , 2.28 ) and early-onset regular smokers : mother OR = 2.89 ( 95 % CI = 2.12 , 3.94 ) , partner OR = 2.50 ( 95 % CI = 1.85 , 3.37 ) . There was no clear evidence for a dose – response effect of either mother or partner smoking heaviness on class membership . Maternal rs1051730 genotype was not clearly associated with offspring smoking initiation class in pre-pregnancy smokers ( P = 0.35 ) . Conclusion The association between smoking during pregnancy and offspring smoking initiation does not appear to operate through intrauterine mechanisms OBJECTIVE Smoking during pregnancy is an important problem in the Netherl and s. We tested the effectiveness of a health counseling method by midwives using a RCT . METHODS Four provinces with 42 practice s including 118 midwives were r and omly assigned to the experimental or control condition . Midwives in the experimental group provided brief health counseling , self-help material s on smoking cessation during pregnancy and early postpartum , and a partner booklet . Controls received routine care . The main outcome measures were 7-day abstinence , continuous abstinence , and partner smoking at 6 weeks post-intervention ( T1 ) and 6 weeks postpartum ( T2 ) . RESULTS Multi-level analysis revealed significant differences between both conditions at T1 and T2 using intention-to-treat analysis . Nineteen percent of the experimental group reported 7-day abstinence compared to 7 % of the control group at T1 , and 21 and 12 % , respectively , at T2 . For continuous abstinence these percentages were 12 % in the experimental group and 3 % in the control group . The partner intervention was not successful . CONCLUSION The intervention result ed in significant effects on smoking behavior for pregnant women , but not for partner smoking . PRACTICE IMPLICATION S The program realized short-term effects . An important precondition is that midwives need a proper training Purpose . Despite high rates of spontaneous and assisted smoking cessation during pregnancy , postpartum maintenance is disappointingly low . Predictors of return to smoking remain unclear , thus limiting the development of interventions that could protect the health of women and their children . This study followed women who had participated in a prenatal smoking cessation intervention trial and successfully stopped smoking to address two aims : ( 1 ) describe the probability of relapse in confirmed quitters during the first 6 months after the birth , and ( 2 ) identify factors that increase relapse . Design . Prospect i ve design during pregnancy and retrospective report at 6 months postpartum used survival analysis with return to smoking as the dependent variable and the Cox proportional hazards regression technique . Measures . Question naires were used at the first prenatal visit and telephone interviews at the 26th week of pregnancy and 6 months postpartum . Nonsmoking after the 20th week was measured by urine cotinine tests ( m = 3 ) ; nonsmoking postpartum was measured by retrospective self-report . Setting . The setting was an HMO-based group practice in Los Angeles . Subjects . Subjects were white , black , and Hispanic women ( n = 127 ) available for follow-up . Results . The proportion of the sample classified as relapsers at 6 months postpartum was 62.9 % . The final model identified the following risk factors for smoking : taking puffs in late pregnancy and having friends who smoke at the first prenatal visit , less confidence in mid-pregnancy that they could maintain nonsmoking postpartum , and a partner who smokes postpartum . Conclusions . Intervention should begin in late pregnancy , and smoking networks , including partner smoking , should be addressed AIM To determine the postpartum smoking relapse rate among women in Japan who quit smoking during pregnancy and to clarify factors related to smoking relapse . METHODS A self-administered question naire survey was conducted as a cross-sectional study of all mothers of children who underwent health checkups after birth in r and omly selected municipalities in Japan from May to July 2009 . Using valid data of 20,601 mothers , smoking rate was calculated . In addition , χ(2 ) -test and multiple logistic regression analysis were used to clarify related factors to the smoking relapse . RESULTS The smoking rates among women were 15.8 % at the time when they became pregnant , 5.1 % during pregnancy and 11.3 % after giving birth . Among women who smoked at the time they became pregnant , the smoking rate during pregnancy was 31.1 % . Among women who quit smoking during pregnancy , the postpartum smoking relapse rate was 41.0 % . The odds ratios ( 95 % confidence interval ) for factors in smoking relapse were 0.72 ( 0.60 - 0.88 ) for women spending time with their child in a relaxed mood , 0.67 ( 0.47 - 0.94 ) for women having someone to talk to on the Internet about childrearing , 1.94 ( 1.60 - 2.35 ) for women who worked and 3.37 ( 2.61 - 4.35 ) for women whose partner smoked after they gave birth . CONCLUSION It is hoped that future research will establish methods to further support smoking cessation and the continuation of smoking cessation after childbirth , and develop mechanisms to spread knowledge about the harm of smoking in society and encourage women not to start Background Low socioeconomic status ( SES ) exacerbates the high rate of smoking relapse in women following childbirth . Purpose This study examined multiple models of potential mechanisms linking SES and postpartum smoking relapse  among women who quit smoking due to pregnancy . Methods Participants were 251 women enrolled in a r and omized clinical trial of a new postpartum smoking relapse prevention intervention . Four models of the prepartum mechanisms linking SES and postpartum smoking relapse were evaluated using a latent variable modeling approach . Results Each of the hypothesized models were a good fit for the data . As hypothesized , SES indirectly influenced postpartum smoking relapse through increased prepartum negative affect/stress , reduced sense of agency , and increased craving for cigarettes . However , the model that included craving as the sole final pathway between SES and relapse demonstrated superior fit when compared with all other models . Conclusions Findings have implication s for future interventions that aim to reduce postpartum relapse The majority of women who quit smoking during pregnancy relapse postpartum and many experience increased depressive symptoms and concerns about body shape and weight . Given the relationship of weight concerns and negative mood to smoking relapse , interventions design ed to address the postpartum experience are indicated . However , there are several challenges to research with postpartum women . We describe the rationale of a r and omized controlled trial of postpartum smoking relapse prevention intervention and discuss methods to address the specific challenges to recruiting , retaining and conducting health behavior interventions among postpartum former smokers . Pregnant women who had quit smoking for at least one month prior to the 34 week of pregnancy and who were motivated to stay quit postpartum were recruited . Women were r and omized either to a postpartum specific intervention design ed to address concerns about mood , stress and weight using cognitive-behavioral techniques or to a support-only condition design ed to control for time and attention . Intervention continues through six months postpartum and women complete follow-up assessment s at 12- , 24- and 52-weeks after delivery . Women ( n=300 ) who had quit smoking as a result of pregnancy were recruited and are being followed . The intervention described in this report is design ed to address stress , negative mood and concerns about weight that mediate smoking relapse postpartum to sustain abstinence and improve maternal and infant health BACKGROUND The majority of women who quit smoking as a result of pregnancy will resume smoking during the first 6 months postpartum . Evidence suggests that changes in depressive symptoms , perceived stress , and concerns about weight may relate to postpartum smoking relapse . PURPOSE This study was design ed to prospect ively evaluate the relationship of mood and weight concerns to postpartum smoking among women who quit smoking during pregnancy . METHODS Pregnant women who had quit smoking ( N=183 ) were recruited between February 2003 and November 2006 . Women completed assessment s of mood ( depressive symptoms , perceived stress , positive and negative affect ) and weight concerns during the third trimester of pregnancy and at 6 , 12 , and 24 weeks postpartum . Self-reported smoking status was verified by expired-air carbon monoxide and salivary cotinine at each assessment . Cox regression analyses in which mood and weight concerns were treated as time-dependent covariates were conducted in 2007 and 2009 . RESULTS By 24 weeks postpartum , 65 % of women had resumed smoking . Smoking-related weight concerns increased risk of relapse , and positive affect and self-efficacy for weight management without smoking decreased risk of relapse postpartum . Moreover , after controlling for variables previously related to postpartum relapse , weight concerns remained significantly related to smoking relapse . CONCLUSIONS Smoking-related weight concerns and positive affect increase the likelihood that a woman will resume smoking postpartum . Moreover , weight concerns appear to be salient even in the context of other factors shown to affect postpartum smoking . This study suggests that interventions may need to address women 's weight concerns and mood to help sustain smoking abstinence after childbirth OBJECTIVES The aim of the r and omized trial was to evaluate the risk of smoking relapse one year after delivery among the women who quit smoking during pregnancy . MATERIAL S AND METHODS The study was carried out in 2002 and 2003 and included the collection of data on smoking relapse within one year after delivery among 175 women who participated in the r and omized smoking cessation trial and quit smoking during pregnancy . RESULTS About 50 % of women who quit smoking during pregnancy relapsed into that habit within 12 months postpartum . The analysis of women who quit smoking before 14 weeks of pregnancy revealed a significantly higher risk of smoking relapse after delivery for women with the higher level of smoking addiction indicated by the Fagerström test ( OR = 5.0 ; 95 % CI : 1.5 - 16.2 ) . Compared to the control group , spontaneous quitters who participated in intervention activities during pregnancy showed lower risk of smoking relapse within one year after giving birth ( OR = 0.3 ; 95 % CI : 0.1 - 0.9 ) . In the group of women who quit smoking after 14 weeks of gestation , the risk of smoking relapse postpartum was significantly higher for those with the higher Fagerström test score ( OR = 4.8 ; 95 % CI : 1.6 - 14.1 ) . The risk of smoking relapse 12 months after delivery was lower for spontaneous quitters who participated in the intervention during pregnancy and for women who quit smoking after participation in the intervention activities than for controls ( OR = 0.03 ; 95 % CI : 0.01 - 0.2 , OR = 0.1 ; 95 % CI : 0.03 - 0.6 ) . CONCLUSIONS Women who had higher score in the Fagerström test before quitting smoking had significantly higher risk of smoking relapse within 12 months after delivery . Anti-smoking intervention during pregnancy helps women to maintain smoking abstinence after delivery Background Smoking cessation interventions in pregnancy could influence a woman 's social behaviour and her partner 's smoking behaviour , but this has not been examined in any published r and omized trials . Method 918 women smoking at booking for antenatal care were enrolled in a cluster-r and omized trial of three interventions : st and ard care , self-help manual and enhanced stage-based counselling , or self-help manual , enhanced stage-based counselling and use of an interactive computer program . The outcomes were change in social 
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Conclusions Of the factors found to be associated with PPRS , intending to quit smoking only for the duration of pregnancy , partner/household member smoking and confidence to remain abstinent are those most likely to have a direct , causal impact on smoking behavior after childbirth , and need to be considered when design ing interventions to prevent PPRS .