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Smoking During Pregnancy

Narrative

Smoking during pregnancy can have a negative impact on the health of women, infants, and children by increasing the risk of fertility problems and pregnancy complications, as well as preterm birth, low birth weight, and sudden infant death syndrome—some of the leading causes of infant mortality.1 Smoking cessation prior to and any time during pregnancy carries benefits, especially considering the many additional risks of postnatal tobacco smoke exposure for infants and children including respiratory infections, ear infections, and asthma.1

In 2007–2009, 12.5 percent of recent mothers in a 32-State area reported that they had smoked in the last 3 months of pregnancy. Smoking in the last 3 months of pregnancy varied significantly by race and ethnicity. About one-quarter of non-Hispanic American Indian/Alaska Native mothers (26.0 percent) reported having smoked in the last 3 months of pregnancy, while less than 5 percent of non-Hispanic Asian and Hispanic mothers reported doing so (2.3 and 3.8 percent, respectively). Smoking in the last 3 months of pregnancy also varied by maternal education, ranging from 2.3 percent among mothers with at least 16 years of education to about 20 percent among mothers with 12 or fewer years of education (data not shown in graph images or in data tables on this site).

Due to awareness of the neonatal health consequences of smoking, pregnancy may be a time of heightened motivation to quit. In 2007–2009, 47.3 percent of mothers in a 32-State area who reported smoking in the 3 months prior to pregnancy had not smoked in the last 3 months of pregnancy. Prenatal smoking cessation rates increased with maternal education, ranging from 32.2 percent among mothers with less than 12 years of education to 74.5 percent among mothers with 16 or more years of education. Hispanic and non-Hispanic Asian mothers had the highest rates of smoking cessation at about 67 percent, while fewer than half of mothers of other racial and ethnic groups had quit smoking during pregnancy (data not shown in graph images or in data tables on this site). In addition to clinical screening and counseling,2 increases in State tobacco taxes and smoke-free laws have been shown to improve prenatal smoking cessation.3

1 U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010. Accessed 08/24/12.

2 U.S. Preventive Services Task Force. Counseling and Interventions to Prevent Tobacco Use and Tobacco-Caused Disease in Adults and Pregnant Women: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement. Ann Intern Med 2009;150:551-55

3 Adams EK, Markowitz S, Kannan V, Dietz PM, Tong VT, Malarcher AM. Reducing prenatal smoking: the role of state policies. Am J Prev Med. 2012 Jul;43(1):34-40

Graphs

Data

Smoking Cessation During Pregnancy,* by Maternal Education, 2007-2009**

Percent of Mothers:

  • Total: 47.3
  • Less than 12 Years: 32.2
  • 12 Years: 43.6
  • 13-15 Years: 54.0
  • 16 Years or More: 74.5

*Defined as the proportion of mothers who reported not smoking in the last 3 months of pregnancy among those who reported smoking in the three months prior to pregnancy.
**Includes data from a total of 32 States and New York City; 25 States contributed all 3 years; mothers completed surveys between 2 and 9 months postpartum.

Source: Centers for Disease Control and Prevention, Pregnancy Risk Assessment Monitoring System, 2007-2009. Analysis conducted by the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.

Cigarette Smoking in the Last 3 Months of Pregnancy, by Race/Ethnicity, 2007-2009*

Percent of Mothers:

  • Total: 12.5
  • Non-Hispanic White: 15.8
  • Non-Hispanic Black: 10.7
  • Hispanic: 3.8
  • Non-Hispanic American Indian/Alaska Native: 26.0
  • Non-Hispanic Asian: 2.3
  • Non-Hispanic Native Hawaiian/Other Pacific Islander: 13.4
  • Non-Hispanic Multiple Races: 18.6

*Includes data from a total of 32 States and New York City; 25 States contributed all 3 years; mothers completed surveys between 2 and 9 months postpartum.

Source: Centers for Disease Control and Prevention, Pregnancy Risk Assessment Monitoring System, 2007-2009. Analysis conducted by the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.