The Transdiagnostic Nature of Cravings: Smoking Cessation and Food Craving in Pregnancy.

OBJECTIVES: Smoking cessation prior to pregnancy is strongly encouraged due to the adverse effects of tobacco use on the developing fetus, but appears to also increase risk of excess gestational weight gain (GWG). Smoking cessation has previously been shown to cause weight gain in non-pregnant individuals, in part due to an increase in food craving frequency. Food craving frequency in pregnancy is a known predictor of excess GWG, but has not yet been examined in relation to pre-pregnancy smoking status. This study sought to test the hypothesis that pre-pregnancy smoking cessation elevates excess GWG risk via an increase in food craving frequency.

METHODS: Pregnant women (n = 82) completed measures of pre-pregnancy tobacco use and current general and specific food cravings. Gestational weight gain was calculated based on participant self-report of pre-pregnancy weight and data on weight prior to delivery culled from medical records.

RESULTS: Pre-pregnancy tobacco use was associated with significantly greater food craving frequency in pregnancy (p = .05), specifically for high-fat and fast-foods (both p < .05), compared to women who did not smoke. Emotional and physiological aspects of cravings accounted for 35% of the variance in excess GWG (p < .03).

CONCLUSIONS: Pre-pregnancy smoking appears predictive of food raving frequency in pregnancy and could thus contribute to excess GWG risk. Findings highlight the importance of incorporating strategies for managing cravings into behavioral interventions promoting healthy GWG for women endorsing pre-pregnancy tobacco use.