Timing of Prenatal Smoking Cessation or Reduction and Infant Birth Weight: Evidence from the United Kingdom Millennium C
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Timing of Prenatal Smoking Cessation or Reduction and Infant Birth Weight: Evidence from the United Kingdom Millennium Cohort Study Ji Yan • Peter A. Groothuis
Springer Science+Business Media New York 2014
Abstract Smoking during pregnancy is a key contributor to poor infant health. Our study presents a dynamic relationship between the timing of prenatal smoking cessation or reduction and infant birth weight. Using a large representative dataset of a birth cohort in the United Kingdom, we apply regression analysis to examine the influences of cessation in smoking or reduction in smoking intensity at different months or trimesters on infant birth weight. For robustness checks, we use a rich set of additional covariates, a series of variable selection procedures, alternative birth outcome measures, and stratified samples. We find robust evidence that mothers who quit smoking by the third month of pregnancy or the end of the first trimester have infants of the same weight as those infants of nonsmokers. However, we find smoking cessation in the fourth month or any time beyond is associated with substantially lower infant birth weights. Two-thirds of the total adverse smoking impact on infant birth weight occurs in the second trimester. Our study also shows mothers who smoke throughout pregnancy but cut smoking intensity by the third month in pregnancy deliver infants of the same weight as those infants born to persistent light smokers. Our research suggests the efficacy of prenatal smoking cessation services can be significantly improved, if health professionals can encourage more pregnant women to quit smoking or reduce smoking intensity timely by the end of the first trimester.
J. Yan (&) P. A. Groothuis Department of Economics, Appalachian State University, ASU Box 32051, Boone, NC 28608, USA e-mail: [email protected] P. A. Groothuis e-mail: [email protected]
Keywords Prenatal smoking Timing of smoking cessation Timing of smoking reduction Birth weight
Introduction Prenatal smoking is a key contributor to poor infant health in developed countries. Since the seminal work of Simpson [1], a number of studies have consistently found prenatal smoking is associated with a reduction of birth weight of offspring by 150–250 grams (g) [2]. In addition, previous research has also linked smoking during pregnancy to many other adverse birth outcomes such as low birth weight, preterm birth, intrauterine growth retardation, placental abruption, and sudden infant death syndrome [3– 5]. Despite voluminous evidence on the smoking’s harmful impacts on infant health, the prevalence of maternal smoking is still quite high in industrial countries [6]. Tong et al. [7] finds about 22–24 % of women in the United States smoked just before or during pregnancy in 2000–2005. In the same period, 33–35 % of women across the United Kingdom (UK) reported smoking prior to or during pregnancy, and about 60 % of these smokers had smoked throughout pregnancy [8]. Given the large percentage of prenatal smokers and the detrimental
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