Maternal and Child Health Journal

, Volume 18, Issue 1, pp 146–152

Comprehensive Smoke-Free Policies: A Tool for Improving Preconception Health?

  • Elizabeth G. Klein
  • Sherry T. Liu
  • Elizabeth J. Conrey

DOI: 10.1007/s10995-013-1247-4

Cite this article as:
Klein, E.G., Liu, S.T. & Conrey, E.J. Matern Child Health J (2014) 18: 146. doi:10.1007/s10995-013-1247-4


Lower income women are at higher risk for preconception and prenatal smoking, are less likely to spontaneously quit smoking during pregnancy, and have higher prenatal relapse rates than women in higher income groups. Policies prohibiting tobacco smoking in public places are intended to reduce exposure to secondhand smoke; additionally, since these policies promote a smoke-free norm, there have been associations between smoke-free policies and reduced smoking prevalence. Given the public health burden of smoking, particularly among women who become pregnant, our objective was to assess the impact of smoke-free policies on the odds of preconception smoking among low-income women. We estimated the odds of preconception smoking among low-income women in Ohio between 2002 and 2009 using data from repeated cross-sectional samples of women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A logistic spline regression was applied fitting a knot at the point of enforcement of the Ohio Smoke-free Workplace Act to evaluate whether this policy was associated with changes in the odds of smoking. After adjusting for individual- and environmental-level factors, the Ohio Smoke-free Workplace Act was associated with a small, but statistically significant reduction in the odds of preconception smoking in WIC participants. Comprehensive smoke-free policies prohibiting smoking in public places and workplaces may also be associated with reductions in smoking among low-income women. This type of policy or environmental change strategy may promote a tobacco-free norm and improve preconception health among a population at risk for smoking.


Smoking Policy Low-income Women WIC Preconception health 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Elizabeth G. Klein
    • 1
  • Sherry T. Liu
    • 1
  • Elizabeth J. Conrey
    • 2
    • 3
  1. 1.Division of Health Behavior and Health PromotionThe Ohio State University College of Public HealthColumbusUSA
  2. 2.State Epidemiology Office, Ohio Department of HealthColumbusUSA
  3. 3.Division of Reproductive HealthCenters for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health PromotionAtlantaUSA

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