Tobacco and nicotine delivery product use in a national sample of pregnant women

Abstract

Monitoring use of tobacco products among pregnant women is a public health priority, yet few studies in U.S. national samples have been reported on this topic. We examined prevalence and correlates of using cigarettes, e-cigarettes, and other tobacco/nicotine delivery products in a U.S. national sample of pregnant women. Data were obtained from all pregnant women (≥ 18 years) in the first wave of the Population Assessment of Tobacco and Health (PATH, 2013–2014) Study (N = 388). Prevalence of current and prior use of tobacco/nicotine products was examined overall and among current cigarette smokers. Multiple logistic regression was used to examine correlates of use of cigarettes, e-cigarettes, hookah and cigars. Overall prevalence was highest for cigarettes (13.8%), followed by e-cigarettes (4.9%), hookah (2.5%) and cigars (2.3%), and below 1% for all other products. Prevalence of using other tobacco products is much higher among current smokers than the general population, with e-cigarettes (28.5%) most prevalent followed by cigars (14.0%), hookah (12.4%), smokeless (4.7%), snus (4.6%), and pipes (2.1%). Sociodemographic characteristics (poverty, low educational attainment, White race) and past-year externalizing psychiatric symptoms were correlated with current cigarette smoking. In turn, current cigarette smoking and past year illicit drug use were correlated with using e-cigarettes, hookah, and cigars. These results underscore that tobacco/nicotine use during pregnancy extends beyond cigarettes. The results also suggest that use of these other products should be included in routine clinical screening on tobacco use, and the need for more intensive tobacco control and regulatory strategies targeting pregnant women.

Use of higher-nicotine/tar-yield (regular full-flavor) cigarettes is associated with nicotine dependence and smoking during pregnancy among U.S. women

“…Seeing the same pattern where the proportion of women using full-flavor cigarettes increased as prevalence of smoking decreased between those late compared to early in pregnancy further suggests that those using higher estimated yield cigarettes are not quitting during pregnancy at the same rate as those using lower estimated yield brands. The results from the multivariate model indicate that this overrepresentation of full-flavor cigarette use during pregnancy is independent of other socio-demographics, psychiatric characteristics, or smoking characteristics known to be associated with using full-flavor cigarettes (Higgins et al, 2016a) as well as smoking during pregnancy (Kurti et al, 2017)—younger age, lower educational attainment, race/ethnicity, poverty, drug use disorders, heavier smoking, and early smoking initiation.…”

“…The present study focused exclusively on associations between cigarette type and likelihood of smoking during pregnancy. Certainly other factors in addition to cigarette type predict smoking during pregnancy and that topic is being addressed in other contributions to this special issue (Kurti et al, 2017). Those limitations notwithstanding, we believe the present study provides new knowledge on an important topic that has the potential to inform researchers, clinicians, and policy makers about risks associated with use of full-flavor cigarettes among women of reproductive age.…”

An update on prevalence and risk of snus and nicotine replacement therapy during pregnancy and breastfeeding

“…Overall, the use of snus in pregnancy reported in the three countries with available data was <1% in the USA, 1.1% in Sweden and 3.4% in Norway .…”

“…The three studies reporting the prevalence of snus use in or after pregnancy included one population‐based cohort from Sweden, one from the USA and one register study from Norway (Table ). Data were obtained from national birth register , a survey and electronic birth records based on self‐reports by the study subjects. The number of respondents ranged from 388 to 1 371 274.…”

Editorial for the special issue on behavior change, health, and health disparities 2017

“…Department of Health and Human Services, 2014). Thus, in this Special Issue we invited contributions on prevalence of cigarette smoking and use of other tobacco products among pregnant women (Higgins et al, 2017, in this issue; Kurti et al, 2017, in this issue), socioeconomically young adults (Villanti et al, 2017, in this issue), sexual minorities (Nayak et al, 2017, in this issue), and those residing in rural geographical areas (Doogan et al, 2017, in this issue). With the difficulties in promoting smoking cessation in these highly vulnerable populations, attention has appropriately turned to possible harm reduction strategies that might better protect these populations from the adverse health impacts of cigarette smoking, including substituting e-cigarettes for combusted tobacco cigarettes and reducing the maximal nicotine content of cigarettes to reduce the addiction potential of cigarettes smoking.…”