February 9, 2007

Cigarette Use among Pregnant Women and Recent Mothers

The Surgeon General's 2004 report on the health consequences of smoking indicates that smoking during pregnancy increases the risk of premature delivery, low-birth-weight infants, and stillbirth.¹ The same report cites studies suggesting that women who stop smoking by the first trimester give birth to infants with weight and body measurements comparable with those of infants of nonsmokers. Other studies cited by the Surgeon General suggest that smoking in the third trimester is particularly harmful. However, there are also health consequences associated with smoking after pregnancy. Children of parents who smoke are at an increased risk for respiratory illnesses, asthma, middle ear disease, and decreased lung function.²

The National Survey on Drug Use and Health (NSDUH) asks female respondents aged 12 to 44 whether they are currently pregnant and how many months pregnant they are. NSDUH also asks respondents about their past month use of cigarettes. This report examines cigarette use among three categories of women aged 15 to 44: (1) pregnant women, (2) recent mothers, and (3) women who were not pregnant and not recent mothers.³ Pregnant women are defined as women who were pregnant at the time of the survey. Recent mothers are defined as women aged 15 to 44 who were not pregnant at the time of the survey but who gave birth during the prior year. Nonpregnant, not recent mothers are defined as women aged 15 to 44 who were not pregnant at the time of the interview and who did not have a biological child under 1 year old in the household. All findings presented in this report are annual averages based on combined 2002 to 2005 NSDUH data.

In 2002-2005 among women aged 15 to 44, pregnant women (17.3 percent) and recent mothers (23.8 percent) were less likely to have smoked cigarettes in the past month than nonpregnant women who were not recent mothers (30.6 percent) (Figure 1). Additionally, pregnant women were less likely than recent mothers to have smoked cigarettes in the past month. These data suggest a reduction in past month smoking during pregnancy and resumption in smoking after giving birth.

Figure 1. Past Month Cigarette Use among Women Aged 15 to 44, by Pregnancy Status*: 2002-2005

In each category of women aged 15 to 44, the majority of those who smoked cigarettes during the past month smoked daily. Among past month smokers, 64.6 percent of recent mothers, 62.2 percent of pregnant women, and 60.2 percent of nonpregnant women who were not recent mothers smoked every day of the month.

Pregnant women aged 15 to 17 (24.3 percent) and those aged 18 to 25 (27.1 percent) were more likely than those aged 26 to 44 (10.6 percent) to have smoked cigarettes in the past month (Table 1). This is also true for recent mothers, with 33.4 percent of those aged 15 to 17, 37.3 percent of those aged 18 to 25, and 15.9 percent of those aged 26 to 44 smoking in the past month. However, among nonpregnant women who were not recent mothers, women aged 18 to 25 were more likely than women aged 15 to 17 or those aged 26 to 44 to have smoked in the past month.

In each of the three categories, white women were more likely than black or Hispanic women to have smoked cigarettes in the past month, and women with annual family incomes of less than $20,000 were more likely than those with higher family incomes to have done so.

Pregnant women aged 15 to 44 were more likely to have smoked cigarettes during their first trimester (22.9 percent) than during their second (14.3 percent) or third (15.3 percent) trimesters (Figure 2).⁴ In the first trimester of pregnancy, women aged 18 to 25 were more likely than those aged 26 to 44 to have smoked cigarettes in the past month (Table 2). During the second trimester, women aged 15 to 17 and women aged 18 to 25 were more likely than those aged 26 to 44 to have smoked cigarettes in the past month. However, during the third trimester, past month cigarette use was similar among pregnant women aged 15 to 17 (13.1 percent) and those aged 26 to 44 (10.3 percent), while those aged 18 to 25 (23.9 percent) had the highest rate of past month cigarette use.

Figure 2. Past Month Cigarette Use among Pregnant Women* Aged 15 to 44, by Trimester***: 2002-2005

White women who were pregnant were more likely to have smoked cigarettes during each trimester than pregnant women who were black or Hispanic. Past month cigarette use by trimester generally declined with higher income. For example, 26.3 percent of pregnant women with annual family incomes of less than $20,000 smoked cigarettes during the third trimester of pregnancy compared with 3.9 percent of pregnant women with annual incomes of $75,000 or more. Among women aged 18 to 44, pregnant women with a college education were less likely to have smoked cigarettes during each trimester than pregnant women with less education.

This page was last updated on June 19, 2008.

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