Cigarette Smoking During Pregnancy: United States, 2016

Questions for Patrick Drake, Health Statistician and Lead Author of “Cigarette Smoking During Pregnancy: United States, 2016.”

Q: Why did you decide to examine smoking during pregnancy?

PD: Questions on tobacco use during pregnancy were first introduced on the US certificate of live birth in 2003, but not all states reported that information until 2016. NCHS’s 2016 natality file provides the first look at nationally representative rates of smoking during pregnancy in the United States from vital statistics data.

Q: Has the National Vital Statistics System ever examined cigarette smoking during pregnancy in the past?

PD: NCHS produced a report on the topic using data from the National Vital Statistics System in 2016. That report presents levels of smoking during pregnancy as well as smoking cessation rates in 46 states and the District of Columbia for 2014.

Q: What differences or similarities did you see among race and ethnic groups, and various demographics, in this analysis?

PD: Smoking rates varied widely by state, maternal age, race and Hispanic origin, and by maternal education:

• Women in West Virginia smoked during pregnancy about five times as often as women in the States with the lowest smoking rates.
• Non-Hispanic white women smoked during pregnancy nearly six times as often as Hispanic women, and nearly twice as often as non-Hispanic black women.
• While less than 1.0% of women with a bachelor’s degree or higher smoked during pregnancy, 12.2% of women with a high school diploma or GED smoked during pregnancy.

Q: What is the take home message in this report?

PD: It has been well established that maternal tobacco use during pregnancy is linked to a host of negative infant and child outcomes.  Despite the well-understood risk to mother and child, still about one of every 14 women in the United States smoked during pregnancy. These levels do vary widely by state, maternal age, race and Hispanic origin, and education, but any amount of smoking during pregnancy is too much. These data can be used to better identify which women might be at greater risk of smoking during pregnancy and better inform future preventative strategies.