Mothers Who Smoke While Pregnant

Publication Date:

Nov 05, 2018

Key facts about mothers smoking while pregnant

• From 1989 to 2006, the percentage of all births where mothers reported smoking during pregnancy decreased by about half, from 20 to 10 percent. Slower declines occurred from 2006 to 2016, when the rate hit 7 percent. However, caution is recommended in interpreting changes over time; before 2016, not all states had adopted a uniform way of collecting these data.
• In 2016, mothers reported smoking during pregnancy in 16 percent of births to American Indian or Alaska Native mothers, compared with 11 percent of births to non-Hispanic white mothers, 6 percent of births to black mothers, 2 percent of births to Hispanic mothers, and 1 percent of births to Asian or Pacific Islander mothers.
• In 2016, pregnant women (ages 20 and older) with a bachelor’s degree or higher (1 percent) were less likely to smoke than those who had some college or an associate’s degree, a high school diploma, or a ninth through twelfth grade education (8, 12, and 16 percent, respectively).

 

Trends in mothers smoking while pregnant

From 1989 to 2006 [1], the percentage of all births where mothers reported they smoked during pregnancy decreased by about half, from 20 to 10 percent. Among teen mothers ages 15 to 19, the percentage reporting smoking during pregnancy increased slightly from 1994 to 1999 (from 17 to 18 percent), then steadily declined until 2003. Trends were similar for births to the youngest teen mothers (i.e., those under age 15). The latest data show that, among all births, the proportion where mothers reported they smoked during pregnancy was 7 percent in 2016; among births to teen mothers ages 15 to 19, the proportion who smoked was 9 percent. Among teen mothers under 15, 3 percent smoked during pregnancy in 2016  (Appendix 1).

Differences by race and Hispanic origin2

American Indian/Alaska Native women report the highest rates of smoking during pregnancy, followed by non-Hispanic white women and black women. In 2016, in 16 percent of births to American Indian or Alaska Native mothers, 11 percent of births to non-Hispanic white mothers, and 6 percent of births to black mothers, mothers smoked during pregnancy. In contrast, in only 1 percent of births to Asian or Pacific Islander women and 2 percent of births to Hispanic women did mothers report they smoked during pregnancy (Appendix 1).

Smoking rates among subgroups of Hispanic mothers vary substantially. Among births to Hispanic mothers in 2016, the share where mothers smoked during pregnancy ranged from 0.5 percent among Central and South American women, to 6 percent among Puerto Rican women (Appendix 1).

Differences by age

Young women ages 18 to 24 report smoking during pregnancy at higher rates than women ages 25 years and older or women ages 15 and younger. In 2016, mothers smoked during pregnancy in 10 percent of births to teens ages 18 to 19 and 11 percent of births to women ages 20 to 24, compared with 8 percent or less of births to women ages 25 and older, and 3 percent of births to women ages 15 and younger  (Appendix 1).

 

Differences by mother’s education3 

The lowest smoking rates among pregnant women (ages 20 and older only) are for those who have earned a bachelor’s degree or higher. In 2016, in less than 1 percent of births to these women did the mother smoke during pregnancy. In contrast, smoking was reported for 8 percent of births where women had some college or an associate’s degree, 12 percent where they had a high school diploma, and 16 percent of births to women with a ninth through twelfth grade education. In 4 percent of births to mothers with an eighth grade education or less, the mother smoked while pregnant (Appendix 1).

Other estimates

State and local estimates

2003 to 2016 estimates (for those states using the 2003 birth certificate revision) of the percentage of births to mothers who smoked during pregnancy are available at the KIDS COUNT Data Center.
The KIDS COUNT Data Center also has data from 2003 to 2010 at the state level using the 1989 birth certificate revision.

International estimates

Estimates of tobacco use and second-hand smoke exposure among women of reproductive age in 14 countries are available from the Centers of Disease Control and Prevention at
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6143a4.htm?s_cid=mm6143a4_e.

Data and appendices

Data source

• Data for 2007-2016: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. (2018). CDC WONDER [Data tool]. Retrieved from https://wonder.cdc.gov/natality-current.html.
• Detailed Asian race data and teen birth data for 2007-2013: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. (2017). VitalStats [Data tool]. Retrieved from https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm.
• Data for 1990-2006: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. (2008). Health, United States, 2008: with special feature on health of young adults [Table 11]. Retrieved from https://www.cdc.gov/nchs/data/hus/hus08.pdf.

Raw data source

Birth Data, National Vital Statistics System.
http://www.cdc.gov/nchs/nvss.htm

Appendices

Appendix 1. Percentage of Births to Mothers Who Reported They Smoked During Pregnancy, by Selected Characteristics: 1989-2016

Background

Definition

Women are considered smokers if they reported smoking at least one cigarette daily during any trimester of pregnancy.

Because of states’ transition to a new revision of the birth certificate, no complete national-level data are available from 2003 through 2015; for those years, we report on the aggregate data from states using the most prevalent revision.

Data from the two versions are not comparable because the 1989 revision asks a simple yes/no question, whereas the 2003 version asks about amount of smoking in each trimester of pregnancy.
Data through 2006 reflect only those jurisdictions that had not yet adopted the 2003 certificate revision. Data for 2007 forward include only those jurisdictions that have adopted the 2003 certificate revision. Although New York State began using the 2003 revision in 2004, New York City continued to use the 1989 revision until 2008. For details on this change, see http://www.cdc.gov/nchs/nvss/vital_certificate_revisions.htm. For a list of states that did not adopt the 2003 revision prior to 2016, see the “Births: Final data” National Vital Statistics Reports, released annually.

Citation

Child Trends. (2018). Mothers who smoke while pregnant. Retrieved from https://www.childtrends.org/indicators/mothers-who-smoke-while-pregnant. 

Endnotes

1. Monitoring data on maternal smoking during pregnancy is complicated by changes over time in the standard birth certificate used by states. The U.S. standard birth certificate, the source for these data, was revised in 2003; however, states adopted it only gradually. Data from states using the older (1989) revision yield data that are not strictly comparable with data derived from the 2003 revision due to differences in the way the maternal smoking question was asked. See Definition section for more details.
2. Hispanic mothers may be of any race.
3. Estimates by maternal education for mothers who smoke while pregnant include only mothers aged 20 or older.