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Smoking During Pregnancy Rates Trends in a High Smoking Prevalence State, 1990–2009

Gerald L. Hoff, PhD, Felix A. Okah, MD, MS, Jinwen Cai, MD, Yifei Liu, PhD
Volume: 105 Issue: 12 December, 2012

Abstract:

Objective: To assess the trends for smoking during pregnancy for whites and blacks in Missouri, a state with a high prevalence of smoking, for the period 1990–2009.


Methods: Retrospective cohort study of annual pregnancy smoking rates recorded on birth certificates. Trends were assessed by regression analyses for all births, births to whites and blacks, births to whites and blacks in aggregate, and by zip codes within the combined jurisdictions of Kansas City, St Louis City, and St Louis County. Zip code smoking during pregnancy rates matched with the respective zip code race-specific population compositions were analyzed by chi-square tests.


Results: Smoking during pregnancy rates trends for whites and blacks differed significantly during the 2 decades. Although rates for whites declined over time, they were relatively stable from 1999 through 2007. Rates for blacks exhibited a steep decline in the early 1990s, remaining stable after 1995. Within the combined jurisdictions, rates for blacks who smoked during pregnancy surpassed those of whites beginning in 2001. The lack of prenatal care for either race was the only maternal characteristic consistently associated with lack of reduction in smoking during pregnancy. There also were no declines among young birth mothers of either race who had 12 or fewer years of education. Rates of smoking during pregnancy for blacks and whites were highest in zip codes with a ≥50% black population.


Conclusions: Rates for smoking during pregnancy for whites and blacks in Missouri overall have not changed appreciably from 2000 to 2009. Beneficial antismoking during pregnancy effects that could reverse this trend may be achievable via improved access to prenatal care, especially for young, uneducated women.

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References:

1. US Department of Health and Human Services. The health consequences of smoking: a report of the Surgeon General, 2004. http://www.cdc.gov/tobacco/data_statistics/sgr/2004/complete_report/index.htm. Accessed June 18, 2012.
 
2. Shea AK, Steiner M. Cigarette smoking during pregnancy. Nicotine Tob Res 2008; 10: 267–278.
 
3. Cnattingius S. The epidemiology of smoking during pregnancy: smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine Tob Res 2004; 6 (2 suppl): S125–S140.
 
4. Owen L, McNeill A, Callum C. Trends in smoking during pregnancy in England, 1992-7: quota sampling surveys. BMJ 1998; 317: 728.
 
5. Tong VT, Dietz PM, England LJ, et al. Age and racial/ethnic disparities in prepregnancy smoking among women who delivered live births. Prev Chronic Dis 2011; 8: A121.
 
6. Martin JA, Hamilton BE, Ventura SJ, et al. Births: final data for 2009. National Vital Statistics Reports. http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf. Published November 3, 2011. Accessed June 18, 2012.
 
7. Tong VT, Jones JR, Dietz PM, et al. Trends in smoking before, during, and after pregnancy–Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 31 sites, 2000-2005. MMWR Surveill Summ 2009; 58: 1–29.
 
8. Stein CR, Ellis JA, Savitz DA, et al. Decline in smoking during pregnancy in New York City, 1995-2005. Public Health Rep 2009; 124: 841–849.
 
9. Okah FA, Cai J, Dew PC, et al. Are fewer women smoking during pregnancy? Am J Health Behav 2005; 29: 456–461.
 
10. Okah FA, Cai J, Hoff GL. Term-gestation low birth weight and heath-compromising behaviors during pregnancy. Obstet Gynecol 2005; 105: 543–550.
 
11. Okah FA, Hoff GL, Dew P, et al. Cumulative and residual risks of small for gestational age neonates after changing pregnancy-smoking behaviors. Am J Perinatol 2007; 24: 191–196.
 
12. Fitzgerald K, Cai J, Hoff GL, et al. Clinical manifestation of small-for-gestational-age risk pregnancy from smoking is gestational age dependent. Am J Perinatol 2007; 24: 519–524.
 
13. Okah FA, Hoff GL, Dew PC, et al. Ponderal index of the newborn: effect of smoking on the index of the small-for-gestational-age infant. Am J Perinatol 2010; 27: 353–360.
 
14. Eaton DK, Kann L, Kinchen S, et al. Youth Risk Behavior Surveillance—United States, 2009. MMWR Surveill Summ 2010; 59: 1–142.
 
15. McClave A, Rock V, Thorne S, et al. State-specific prevalence of cigarette smoking and smokeless tobacco use among adults—United States, 2009. MMWR Morb Mortal Wkly Rep 2010; 59: 1400–1406.
 
16. McMenamin SB, Halpin HA, Ingram M, et al. State Medicaid coverage for tobacco-dependence treatments—United States, 2009. MMWR Morb Mortal Wkly Rep 2010; 59: 1340–1343.
 
17. Kaufmann R, Francis J, Tynan MA, et al. State tobacco revenues compared with tobacco control appropriations—United States, 1998-2010. MMWR Morb Mortal Wkly Rep 2012; 61: 370–374.
 
18. US Department of Agriculture. Census of Agriculture—2007. http://www.agcensus.usda.gov/Publications/2007/Full_Report/usv1.pdf. Accessed June 18, 2012.
 
19. Stockbauer JW, Land GH. Changes in characteristics of women who smoke during pregnancy: Missouri, 1979-88. Public Health Rep 1991; 106: 52–58.
 
20. Dietz PM, Adams MM, Rochat RW, et al. Prenatal smoking in two consecutive pregnancies: Georgia, 1989-1992. Matern Child Health J 1997; 1: 43–51.
 
21. Missouri Information for Community Assessment (MICA). Jefferson City, MO: Missouri Department of Health and Senior Services.
 
22. US Department of Commerce, Bureau of the Census. 2010 Census. 2010.census.gov. Accessed September 11, 2012.
 
23. US Department of Health and Human Services. Healthy People. http://www.healthypeople.gov. Accessed June 18, 2012.
 
24. Ventura SJ, Hamilton BE, Mathews TJ, et al. Trends and variations in smoking during pregnancy and low birth weight: evidence from the birth certificate, 1990-2000. Pediatrics 2003; 111: 1176–1180.
 
25. Grier SA, Kumanyika S. Targeted marketing and public health. Annu Rev Public Health 2010; 31: 349–369.
 
26. Siahpush M, Jones PR, Singh GK, et al. The association of tobacco marketing with median income and racial/ethnic characteristics of neighbourhoods in Omaha, Nebraska. Tob Control 2010; 19: 256–258.
 
27. Cruz TB, Wright LT, Crawford G. The menthol marketing mix: targeted promotions for focus communities in the United States. Nicotine Tob Res 2010; 12 (2 suppl): S147–S153.
 
28. Luke D, Esmunndo E, Bloom Y. Smoke signs: patterns of tobacco billboard advertising in a metropolitan region. Tob Control 2000; 9: 16–23.
 
29. Dew PC, Guillory VJ, Okah FA, et al. The effect of health compromising behaviors on preterm births. Matern Child Health J 2007; 11: 227–233.
 
30. Okah FA, Mundy DC, Sheehan M, et al. Role of mental illness in drug use by urban pregnant heavy smokers. Am J Perinatol 2004; 21: 299–304.
 
31. Mickens L, Amringer K, Brightman M, et al. Epidemiology, determinants, and consequences of cigarette smoking in African American women: an integrative review. Addict Behav 2010; 35: 383–391.
 
32. Jun HJ, Acevedo-Garcia D. The effect of single parenthood on smoking by socioeconomic status and race/ethnicity. Social Sci Med 2007; 65: 653–666.
 
33. King G, Polednak A, Fagan P, et al. Heterogeneity in the smoking behavior of African American women. Am J Health Behav 2006; 30: 237–246.
 
34. Katz KS, Blake SM, Milligan RA, et al. The design, implementation and acceptability of an integrated intervention to address multiple behavioral and psychological risk factors among pregnant African American women. BMC Pregnancy Childbirth 2008; 8: 22.
 
35. Griffin M, Babb SD, Tynan M, et al. State preemption of local tobacco control policies restricting smoking, advertising, and youth access—United States, 2000-2010. MMWR Morb Mortal Wkly Rep 2011; 60: 1124–1127.
 
36. Harris JK, Geremakis C, Moreland-Russell S, et al. Demographic and geographic differences in exposure to secondhand smoke in Missouri workplaces, 2007-2008. Prev Chronic Dis 2011: 8: A135.
 
37. Cheng KW, Glantz SA, Lightwood JM. Association between smokefree laws and voluntary smokefree-home rules. Am J Prev Med 2011; 41: 566–572.
 
38. Mills AL, White MM, Pierce JP, et al. Home smoking bans among US households with children and smokers. Opportunities for intervention. Am J Prev Med 2011; 41: 559–565.
 
39. Okah FA, Choi WS, Okuyemi KS, et al. Effect of children on home smoking restriction by inner-city smokers. Pediatrics 2002; 109: 244–249.
 
40. Mincieli L, Manlove J, McGarrett M, et al. The relationship context of births outside of marriage: the rise of cohabitation. Child Trend Research Brief #2007-13. http://www.childtrends.org/files/Child_Trends-2007_05_14_RB_OutsideBirths.pdf. Published May 2007. Accessed June 18, 2012.
 
41. Allen AM, Dietz PM, Tong VT, et al. Prenatal smoking prevalence ascertained from two population-based data sources: birth certificates and PRAMS questionnaires, 2004. Public Health Rep 2008; 123: 586–592.
 
42. Dietz PM, Homa D, England LJ, et al. Estimates of nondisclosure of cigarette smoking among pregnant and nonpregnant women of reproductive age in the United States. Am J Epidemiol 2011; 173: 355–359.
 
43. Hoff GL, Cai J, Okah FA, et al. Changes in smoking behavior between first and second pregnancies. Am J Health Behav 2007; 31: 583–590.
 
44. Abrevaya J. Trends and determinants of second-pregnancy smoking among young-adult mothers who smoked during their first pregnancy. Nicotine Tob Res 2008; 10: 951–957.
 
45. Detjen MG, Nieto FJ, Trentham-Dietz A, et al. Acculturation and cigarette smoking among pregnant Hispanic women residing in the United States. Am J Public Heath 2007; 97: 2040–2047.
 
46. Migration Policy Institute. MPI Data Hub. http://www.migrationinformation.org/datahub. Accessed September 11, 2012.

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