Maternal and Child Health Journal

, Volume 18, Issue 1, pp 146–152 | Cite as

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

  • Elizabeth G. KleinEmail author
  • Sherry T. Liu
  • Elizabeth J. Conrey


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 



This study was supported in part by the Health Resources and Services Administration, Maternal and Child Health Bureau’s Graduate Student Internship Program. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. We thank Karen Dalenius and Patricia Brindley (Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention) and Kelly Hetrick (Ohio Department of Health) for technical assistance with the PNSS data.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Elizabeth G. Klein
    • 1
    Email author
  • 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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