Trends in Smoking and Smoking Cessation During Pregnancy from 1985 to 2014, Racial and Ethnic Disparity Observed from Multiple National Surveys

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Maternal and Child Health Journal






Objective: Current report assessed the trends in smoking prevalence and the percentage of smoking cessation during pregnancy among women from three major races/ethnicities.

Methods: Data were collected between 1999 and 2014 from the continuous National Health and Nutrition Examination Survey (NHANES). Smoking habits of women while pregnant with the child sampled by NHANES were assessed retrospectively. A total of 28,090 women who gave live birth between 1985 and 2014 were included. The prevalence ratios (PRs) of smoking and quitting smoking during pregnancy were calculated. The adjusted annual prevalence ratio (aaPR: the ratio associated with a 1-year increase in time) was estimated using logistic regression with the year of birth as a predictor.

Results: With child’s race/ethnicity, gender, and mother’s age controlled, the aaPR of smoking was 0.95 (95% confidence interval 0.92–0.97) for Hispanics, 0.96 (0.94–0.98) for whites, and 0.98 (0.94–1.00) for blacks. The aaPR of quitting smoking was 1.09 (1.02–1.16) for Hispanics, 1.01 (0.97–1.06) for whites, and 1.03 (0.95–1.12) for blacks. Compared with the counterparts aged 35 years or older, pregnant women younger than 20 years were more likely to smoke among whites [PR 1.56 (1.07–2.29)] but less likely among blacks [PR 0.37 (0.26–0.52)].

Conclusions for Practice: Smoking prevalence has been declining continuously for all but at different rates among three major races/ethnicities. The risk profiles of smoking during pregnancy were race/ethnicity specific. Culturally appropriate programs should be developed to further reduce the maternal smoking during pregnancy.