Trends in Smoking and Smoking Cessation During Pregnancy from 1985 to 2014, Racial and Ethnic Disparity Observed from Mu
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Trends in Smoking and Smoking Cessation During Pregnancy from 1985 to 2014, Racial and Ethnic Disparity Observed from Multiple National Surveys Hongxia Li1,2 · Andrew R. Hansen3 · Zachary McGalliard4 · Laura Gover4 · Fei Yan1 · Jian Zhang4
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Objective Current report assessed the trends in smoking prevalence and the percentage of smoking cessation during pregnancy among women from three major races/ethnicities. Methods Data were collected between 1999 and 2014 from the continuous National Health and Nutrition Examination Survey (NHANES). Smoking habits of women while pregnant with the child sampled by NHANES were assessed retrospectively. A total of 28,090 women who gave live birth between 1985 and 2014 were included. The prevalence ratios (PRs) of smoking and quitting smoking during pregnancy were calculated. The adjusted annual prevalence ratio (aaPR: the ratio associated with a 1-year increase in time) was estimated using logistic regression with the year of birth as a predictor. Results With child’s race/ethnicity, gender, and mother’s age controlled, the aaPR of smoking was 0.95 (95% confidence interval 0.92–0.97) for Hispanics, 0.96 (0.94–0.98) for whites, and 0.98 (0.94–1.00) for blacks. The aaPR of quitting smoking was 1.09 (1.02–1.16) for Hispanics, 1.01 (0.97–1.06) for whites, and 1.03 (0.95–1.12) for blacks. Compared with the counterparts aged 35 years or older, pregnant women younger than 20 years were more likely to smoke among whites [PR 1.56 (1.07–2.29)] but less likely among blacks [PR 0.37 (0.26–0.52)]. Conclusions for Practice Smoking prevalence has been declining continuously for all but at different rates among three major races/ethnicities. The risk profiles of smoking during pregnancy were race/ethnicity specific. Culturally appropriate programs should be developed to further reduce the maternal smoking during pregnancy. Keywords Maternal smoking · Pregnancy · Smoking prevalence rate · Smoking cessation · NHANES Abbreviations CI Confidence interval HP2020 Healthy people 2020
* Fei Yan [email protected] * Jian Zhang [email protected] 1
Department of Social Medicine, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, People’s Republic of China
2
Shanghai East Hospital, Tongji University, School of Medicine, Shanghai, China
3
Department of Community Health Behavior and Education, Jiann‑Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA, USA
4
Department of Epidemiology, Jiann‑Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
NHANES National Health and Nutrition Examination Survey PRAMS Pregnancy Risk Assessment Monitoring System SE Standard error
Significance What is already known on this subject? Smoking cessation interventions targeting pregnant women have met with some success. However, this was demonstrated with a short period of time (2004–2008) by the Pregnancy Risk Assess
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