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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

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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.

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Abbreviations

CI:

Confidence interval

HP2020:

Healthy people 2020

NHANES:

National Health and Nutrition Examination Survey

PRAMS:

Pregnancy Risk Assessment Monitoring System

SE:

Standard error

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Acknowledgements

We are indebted to the students, who have contributed substantially to the early drafts with care. The comments and editorial assistance from these students have been especially helpful, Adrian Badana, Gloria Barnett, Bionca Davis, Jamesa Hogges, Ogechi Imala, Krystina Johnson, Sushma Kurella, Wayne Lawrence, Maria Politis, Keisha Pressley, Kayin Robinson.

Funding

The project was done with no specific funding. However, the special training Grant from the School of Public Health, Fudan University, Shanghai, China, made it possible to update the current report with the release of NHANES survey 2013–2014.

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Authors and Affiliations

  1. Department of Social Medicine, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai, 200032, People’s Republic of China

    Hongxia Li & Fei Yan

  2. Shanghai East Hospital, Tongji University, School of Medicine, Shanghai, China

    Hongxia Li

  3. Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA, USA

    Andrew R. Hansen

  4. Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA

    Zachary McGalliard, Laura Gover & Jian Zhang

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  1. Hongxia Li
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  3. Zachary McGalliard
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Correspondence to Fei Yan or Jian Zhang.

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Li, H., Hansen, A.R., McGalliard, Z. et al. Trends in Smoking and Smoking Cessation During Pregnancy from 1985 to 2014, Racial and Ethnic Disparity Observed from Multiple National Surveys. Matern Child Health J 22, 685–693 (2018). https://doi.org/10.1007/s10995-018-2437-x

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