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. 2018 Nov;133(6):644-649.
doi: 10.1177/0033354918793120. Epub 2018 Oct 2.

Striving to Meet Healthy People 2020 Objectives: Trend Analysis of Maternal Smoking

Andrew R Hansen  1 , Toyin O Akomolafe  1 , Zachary McGalliard  2 , Laura Belle-Isle  2 , Jian Zhang  2
Affiliations

Striving to Meet Healthy People 2020 Objectives: Trend Analysis of Maternal Smoking

Andrew R Hansen et al. Public Health Rep. 2018 Nov.

Abstract

Objectives: We examined trends in prevalence rates of smoking and smoking cessation during pregnancy among women in the United States to assess achievement of Healthy People 2020 prevention targets.

Methods: We assessed the smoking habits of 30 667 mothers whose children were born between 1985 and 2014 and who were sampled by the National Health and Nutrition Examination Survey, 1999-2014. Sampled participants were children aged 0-15 at the time of interview; however, an adult proxy-usually the biological mother-responded on the child's behalf and reported information about maternal tobacco use during pregnancy. We calculated prevalence rates, adjusted odds ratios (aORs), and predicted annual increase or decrease of smoking and quitting smoking during pregnancy, adjusting for mother's age at delivery and income level and child's race/ethnicity and sex.

Results: The average annual prevalence of smoking at any time during pregnancy decreased from 25.7% (95% confidence interval [CI], 15.3%-36.0%) in 1985 to 10.1% (95% CI, 7.1%-13.0%) in 2014 ( P < .001), and quitting smoking at any time during the index pregnancy increased from 36.6% (95% CI, 20.3%-52.9%) in 1985 to 54.9% (95% CI, 44.4%-65.4%) in 2008 ( P = .002). The adjusted annual risk of smoking during pregnancy decreased significantly by 3% (aOR = 0.97; 95% CI, 0.95-0.98; P < .001). The prevalence rate of smoking in the year 2020 extrapolated from the current trend would be 6.1%.

Conclusions: Smoking during pregnancy in the United States is declining. However, renewed public health measures are needed to achieve the Healthy People 2020 objectives of preventing smoking among pregnant women in the United States.

Keywords: Healthy People 2020; United States; maternal smoking; pregnancy.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure.
Figure.
Prevalence rates of smoking and percentage of mothers who quit smoking during pregnancy in a sample of mothers with children aged 0-15 (n = 30 667), National Health and Nutrition Examination Survey, United States, 1985-2014. Data source: National Center for Health Statistics, Centers for Disease Control and Prevention. Line indicates best-fitting line, and shading indicates mean 95% confidence intervals. Smoking cessation rate: percentage = –1164 + 0.603 year + e [R 2 = 0.36, N = 24], P = .002 (for birth year). Smoking rate: prevalence = 949.3 – 0.467 year + e [R 2 = 0.85, N = 28], P < .001 (for birth year).
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