Trends in smoking during pregnancy by socioeconomic characteristics in the United States, 2010–2017

Abstract

Background: Maternal smoking during pregnancy remains a public health concern in the United States (US). We examined whether the prevalence of smoking during pregnancy decreased between 2010 and 2017 and how trends differed by demographic subgroups. Methods: We used 2010-2017 data from the National Center for Health Statistics. Rao-Scott Chi-Square tests were performed to compare characteristics between smoking and nonsmoking groups. Cochran-Armitage tests and logistic regression were used to assess overall changes in the prevalence of smoking during pregnancy over time and changes for age, race, and educational attainment subgroups. Results: The prevalence of smoking during pregnancy decreased from 9.2% in 2010 to 6.9% in 2017. In 2017, the prevalence was highest among women aged 20-24 (9.9%), American Indian/Alaskan Natives (15%), and those with a high school diploma or General Educational Development (GED) (12.2%). The prevalence was lowest among women younger than 15 (1.7%), Asian/Pacific Islanders (1%), and those who had a master's degree and higher (0.3%). Prevalence did not decrease significantly over time in the 35-39 age group (4.5 to 4.4%; p = 0.08), and increased dramatically for women with less than a high school diploma from 10.2 to 11.8%; p < 0.0001. Conclusions: Smoking prevalence during pregnancy in the US is declining, but is highest among younger women (20-24), American Indian/Alaska Natives, and women with a high school diploma or GED. In addition, the prevalence has increased for women with the least education. Targeted research and tobacco control interventions could help address the specific needs of these high-risk subpopulations.

Tobacco Consumption during Pregnancy and Its Adverse Pregnancy Outcomes: A Systematic Review

“…This finding was supported by M.Mohsin (2011) and Erin Passmore (2015) in their respective studies reporting women from low Socio-economic status continued smoking during pregnancy (45) (46) . S.Agazba (2020) reported that maternal smoking prevalence is high in less educated women (47) . J.…”

Cigarette Taxes and Smoking in the Long Run

“…Smoking during pregnancy in the United States has been slowly trending downwards for the past several decades (Meernik and Goldstein 2015;Azagba et al 2020). Nevertheless, a substantial number of American women still smoke for some portion of their pregnancy (Azagba et al 2020), risking premature delivery, low birth weight, and congenital defects (Scherman et al…”

Whither weathering? The variable significance of age in Black-White low birth weight disparities

“…On the one hand, the causes of smoking may not have their roots in the same fundamental causes as disparities in other health outcomes. Indeed, on average, Black women are less likely to smoke when pregnant than White women ( Azagba, Manzione, et al, 2020 ; Li et al, 2018 ). Smoking patterns are also highly amenable to social policy, such as higher cigarette taxes and other anti-smoking laws ( Azagba, Shan, & Latham, 2020 ; Evans & Ringel, 1999 ; Friedson & Rees, 2020 ; Levy & Meara, 2006 ; Lien & Evans, 2005 ), suggesting that the root causes of smoking patterns may be variable rather than fundamental.…”