Are empathic processes mechanisms of pregnancy's protective effect on smoking? Identification of a novel target for preventive intervention

Background: Spontaneous cessation and reduction in smoking by pregnant women suggest that concern about others, or empathy, could be a malleable target for intervention. We examined various empathy-related processes in relations to reported and biochemically assessed smoking during pregnancy. Methods: Participants were 154 pregnant women (M = 12.4 weeks gestation, SD = 4.6) who were smoking cigarettes immediately prior to pregnancy recognition (85 had quit and 69 were still smoking at enrollment). Empathy-related processes were measured with performance-based paradigms (affect sharing, empathic concern, and theory of mind) and a speech sample (expressed emotion). Smoking was assessed with timeline follow back interviews and urine cotinine assays. Using zero-inflated Poisson regression models, we tested direct and interactive effects of empathy-related processes with respect to biologically verified smoking cessation (zero portion); and mean cigarettes/day smoked after pregnancy recognition among persistent smokers (count portion). Results: Affect sharing was inversely related to post-recognition cigarettes/day (B(SE) =-0.17(0.07), 95% C.I.-0.30,-0.04, p = .011) and moderated the relationship between pre-recognition smoking and post-recognition smoking consistent with a buffering effect (B(SE) =-.17(0.05); 95% C.I. -0.28,-0.06; p = .002). Other empathy related processes showed neither direct nor interactive effects on smoking outcomes. Conclusions: Further research is recommended to clarify the role of empathy in pregnancy smoking.

Automated summary

Smoking during pregnancy is related to empathy-related processes, specifically affect sharing. Affect sharing is inversely related to the number of cigarettes smoked per day after pregnancy recognition and moderates the relationship between pre-recognition smoking and post-recognition smoking.