Review of the Relationships Among Psychosocial Stress, Secondhand Smoke, and Perinatal Smoking

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To summarize and evaluate the recently published literature in which the relationships among psychosocial stress, smoking, and exposure to secondhand smoke during the perinatal period are examined, and to describe the characteristics and demographics of the samples.

Data Sources:

Electronic databases MEDLINE, Academic Search Complete, CINAHL, Psychology and Behavioral Sciences Collection, and PsychINFO. In addition, hand searches of reference lists supplemented the electronic search.

Study Selection:

English language, peer-reviewed studies published between 2010 and 2015 on the relationships of self-reported or perceived stress, smoking, and secondhand smoke exposure during pregnancy and postpartum were included. Twenty-four studies met the inclusion criteria.

Data Extraction:

Data that specified the relationships among smoking, stress, and secondhand smoke exposure during pregnancy and postpartum were extracted from the studies. A table matrix, available as supplemental material, to summarize the literature and sample characteristics and demographics was created.

Data Synthesis:

Evidence from the included studies supported an association between psychosocial stress specific to pregnancy or from other sources and smoking or smoking relapse during pregnancy or in the postpartum period. In the studies in which it was included, exposure to secondhand smoke was cited as a barrier to abstinence.


It is probable that women who persistently smoke in pregnancy experience elevated stress. Further research with longitudinal designs and inclusion of secondhand smoke as a variable are needed.

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