Facts About Smoking During Pregnancy and
Environmental Tobacco Smoke
Smoking During Pregnancy
Nationally, between 12-20% of all pregnant women smoke.1 In 2008 in North Carolina, 10.4% of all live births were to women who reported smoking during pregnancy, although in some counties as many as 33% of babies were born to women who smoked.2 The evidence of the negative impact of smoking on pregnant women, infants and mothers continues to grow. For example, a recently published study found that continuous smoking during pregnancy increases the likelihood that children will have behavioral and attention deficit problems.3
Please click here for more information by county on the percentage of live births to women who smoked during pregnancy in North Carolina.
This new research adds to the large body of knowledge about the harmful effect of smoking on this population. Women who smoke are less likely to become pregnant, compared to non-smokers. Smoking during pregnancy has been linked to up to 10% of all infant deaths.4 Pregnant smokers are twice as likely to have a low birth weight baby5 and more likely to deliver their babies prematurely.6 Babies whose mothers smoked during their pregnancy are more likely to die from Sudden Infant Death Syndrome (SIDS) than those whose mothers did not smoke.7 Smoking during pregnancy may impair normal fetal brain and nervous system development.8 The direct medical costs of a complicated birth are 66% higher for smokers than for non-smokers, reflecting the greater severity of complications and the more intensive care that is required.9
Environmental Tobacco Smoke
Smoking after the baby is born poses risks for the mother, child, and other household members. Twenty-seven percent of US children aged 6 years and under live with a parent or other family member who smokes; the annual direct medical costs associated with this exposure to parental smoking is estimated at $4.6 billion.11 Environmental tobacco smoke, also known as second-hand smoke, can contribute to an increase in respiratory illnesses in mothers and babies, middle ear infections in children, children with impaired lung function12 and an increase in SIDS.13
The Treating Tobacco Use and Dependence: 2008 Update provides recommendations specific to Tobacco Cessation for Pregnant Women and Protecting Children from Second-Hand Smoke. This guide notes that “whenever possible pregnant smokers should be offered person-to-person psychosocial interventions that exceed minimal advice to quit. Clinicians should offer effective tobacco dependence interventions to pregnant smokers at the first prenatal visit as well as throughout the course of pregnancy.” The guide also notes that cessation counseling delivered in pediatric settings has been shown to be effective in increasing abstinence among parents who smoke, therefore clinicians should ask parents about tobacco use and offer them cessation advice and assistance.”14 Smoking cessation screening and counseling during and after pregnancy must be a core component of every maternity care, family medicine, and pediatric practice. The consequences of neglecting this essential prevention opportunity span generations.
1. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: Final data for 2002. National vital statistics reports; vol 52 no 10. Hyattsville, Maryland: National Center for Health Statistics. 2003, 12.
2. North Carolina State Center for Health Statistics. Risk Factors and Characteristics for 2008 North Carolina Resident Live Births: All Mothers. Accessed December 15, 2009. Available from: http://www.schs.state.nc.us/SCHS/births/matched/2008/all.html>
3. Robinson M, et al. Smoking cessation in pregnancy and the risk of child behavioural problems: A longitudinal prospective cohort study. J Epidemiol Community Health. Published Online First: 24 August 2009 doi:10.1136/jech.2009.088658
4.-8. Women and smoking: A report of the Surgeon General. Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Office of the Surgeon General; Washington, DC, 2001.
9. Centers for Disease Control and Prevention (1997). Medical-care expenditures attributable to cigarette smoking during pregnancy —United States, 1995. Morbidity and Mortality Weekly Report, 46(44), 1048-1050.
11. Aligne CA, Stoddard JJ. Tobacco and Children: An Economic Evaluation of the Medical Effects of Parental Smoking. Archives of Pediatric and Adolescent Medicine 151:648-53 (July 1997)
12. Hu FB, et al., Prevalence of asthma and wheezing in public schoolchildren: association with maternal smoking during pregnancy, Annals of Allergy, Asthma and Immunology 79(1): 80-84 (July 1997)
13. Tager IB, et al., "Maternal smoking during pregnancy: effects on lung function during the first 18 months of life, American Journal of Respiratory and Critical Care Medicine 152(3);977-83 (September 1995)
14. Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.
