RESUMEN
BACKGROUND: Research suggests that pregnancy status (prior, current, and future intention) is associated with differences in perceived harm of e-cigarette use during pregnancy. However, perceptions of health outcomes attributed to cigarette and e-cigarette use during pregnancy have not been explored among a sample of pregnant women who smoke. OBJECTIVES: The purpose of this study was to explore differences in perceived harms of cigarette and e-cigarette use and perceived birth and health outcomes associated with cigarette and e-cigarette use during pregnancy among a sample of pregnant women who currently smoked. METHODS: Using a cross-sectional online survey, we examined perceptions about cigarette and e-cigarette use during pregnancy among a sample of U.S. pregnant women (n = 267) who smoked in the past 30 days. Participants were grouped into categories based on e-cigarette use status (current, past, and never e-cigarette users). Differences between e-cigarette use status and perceived harm (absolute of cigarettes, e-cigarettes, and relative of e-cigarettes) and perceived health outcomes attributed to smoking/e-cigarette use were examined. RESULTS: Among our sample, 45.7%, 39.7%, and 14.6% were current, ever, and never e-cigarette users, respectively. Associations existed between e-cigarette use status and absolute perceived harm of cigarettes, relative perceived harm of e-cigarettes, and perceived health outcomes. Current e-cigarette users believed pregnant women who smoked cigarettes were more likely to lose a child due to miscarriage or sudden infant death syndrome or give birth to a child with low birth weight, reduced lung function, cleft lip, reduced brain function, or attention-deficit/hyperactivity disorder than never e-cigarette users. No associations were found between perceived birth and health outcomes of e-cigarette use by e-cigarette user status. DISCUSSION: Pregnant women who smoked and used e-cigarettes had lower risk perceptions about e-cigarette use during pregnancy than those who only smoked. Health messages and research about the harms of nicotine exposure during pregnancy should address the risks of dual-use versus only e-cigarette use. Additionally, messages about the relative harm of e-cigarettes compared to cigarettes are needed for pregnant women who smoke and have trouble quitting.
RESUMEN
Sexual assault victimization (SAV) histories may impede, increase, or have no effect on women's risk recognition. Yet, even though risk recognition is a component of bystander intervention, the effect of SAV on bystander behaviors is understudied. For example, how different SAV histories, such as the severity of the assault and if women were revictimized since entering college, have not been examined with bystander behaviors; we intended to address this gap in the literature. Building on recent work, we also examined the potential interactive effects of alcohol consumption and SAV history in predicting bystander behaviors. College women (n = 560) completed a web-based survey on alcohol consumption, SAV experiences since entering college, and bystander behaviors in alcohol-involved settings. We found that the effect of SAV history on bystander behavior varied based on alcohol consumption. As women's alcohol consumption increased so did their self-reported engagement in bystander behaviors. For non-victims, increased alcohol consumption had a greater positive effect on their bystander behaviors than victims. However, after a certain quantity of alcohol was consumed, both victims and non-victims reported decreased bystander behavior. Finally, alcohol consumption did not interact with severity of SAV or revictimization status in predicting bystander behavior. Findings suggest alcohol consumption may be more influential on bystander behaviors for women with no history of SAV; however, consuming a greater quantity of alcohol is related to a decrease in bystander behavior-regardless of SAV history. Given these findings, more work is needed to explore when and how alcohol impedes, and potentially encourages, bystander behavior. How SAV histories relate to bystander behaviors also warrants further research.
