CARERC Pilot: Cancer Risk Reduction Through Tobacco Control Among Mothers in Rural Kentucky

Abstract Postpartum is a particularly vulnerable period in the life course for tobacco use and secondhand smoke exposure for mothers, families, and their infants. Smoking rates in Kentucky are among the highest in the United States and conversely, state breastfeeding rates are lower than the national average. Research is lacking on the association of tobacco use and SHS exposure and infant feeding status including breastfeeding duration in rural communities. Additionally, little is known about the association of municipal smoke-free laws and infant feeding status including BF duration, especially in rural communities. The overall purpose of this study is to examine tobacco use and SHS exposure and infant feeding status including breastfeeding duration in mothers residing in rural Kentucky. The specific aims are to 1) determine the association of tobacco use status and SHS exposure status with infant feeding status among mothers living in rural Kentucky, controlling for occupational status and strength of smoke-free laws in county of residence and 2) to determine the association of tobacco use status and SHS exposure status with BF duration among mothers living in rural Kentucky, controlling for occupational status and strength of smoke-free laws in county of residence. A cross-sectional, retrospective design using purposive cluster sampling will examine the association of mothers’ tobacco use status and secondhand smoke exposure status and strength of municipal smoke-free laws with infant feeding status and BF duration among women living in rural areas of Kentucky. A total of 240 mothers aged 18-45, each of whom will have delivered a live infant in the past two years, will be recruited using quota sampling in four groups, with stratification by strength of municipal smoke-free law and tobacco use status. Study inclusion criteria include women who are currently residing in one of the six identified rural Kentucky counties, who have given birth to a live infant within the past two years and speak English. The proposed research study will help inform future cancer prevention and control interventions aimed at tobacco control and breastfeeding programs and policies.