U.S. Department of Health and Human Services, Health Resources and Services Administration

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Smoking During Pregnancy

Smoking during pregnancy can have a negative impact on the health of women, infants, and children by increasing the risk of complications during pregnancy, premature delivery, and low birth weight—leading causes of infant mortality.1 Maternal cigarette use data is captured on birth certificates; however, a revised birth certificate was introduced in 2003 that captures smoking during pregnancy by trimester, as opposed to any time during pregnancy as is assessed with the unrevised birth certificate. As of 2006, the 1989 Standard Certificate of Live Birth (unrevised) was used in 32 States, New York City, and Washington, DC, while 19 States used the revised birth certificate.2

The areas using the revised birth certificate reported higher rates of smoking in pregnancy than those using the unrevised certificate (13.1 versus 9.9 percent, respectively). The proportion of mothers who smoked varied by maternal race and ethnicity. Among women in areas using the revised birth certificate, non-Hispanic American Indian/Alaska Native mothers (27.4 percent) and non-Hispanic White mothers (18.0 percent) were most likely to report having smoked during pregnancy.

Similarly, among women in the unrevised reporting areas, non-Hispanic American Indian/Alaska Native mothers were most likely to have smoked during pregnancy (16.9 percent), followed by non-Hispanic White women (13.2 percent). Non-Hispanic Asian/Pacific Islander and Hispanic mothers were least likely to have smoked during pregnancy in both reporting areas.

Cigarette use also varied by maternal age in 2006. Among women in the revised reporting areas, women under 20 years of age were most likely to have smoked cigarettes during pregnancy (17.3 percent), followed by women aged 20–29 years (15.9 percent). Similarly, 13.5 percent of women under 20 years of age in the unrevised reporting areas smoked during pregnancy, followed by 12.2 percent of women aged 20–29 years.

1 U.S. Department of Health and Human Services. The health consequences of smoking: a report of the Surgeon General. 2004.
2 Martin JA, Hamilton BE, Sutton PD, Ventura SJ, et al. Births: Final data for 2006. National vital statistics reports; vol 57 no 7. Hyattsville, MD: National Center for Health Statistics. 2009. The 19 States using the 2003 Revision of the U.S. Standard Certificate of Live Birth were California, Delaware, Florida, Idaho, Kansas, Kentucky, Nebraska, New Hampshire, New York (excluding New York City), North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Vermont, Washington, and Wyoming.

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