Cigarette Smoking among Pregnant Women During the Perinatal Period: Prevalence and Health Care Provi

Lauren Kipling, PhD, Jennifer Bombard, MSPH^, Xu Wang, PhD, Shanna Cox, MSPH
Cigarette Smoking among Pregnant Women During the Perinatal Period: Prevalence and Health Care Provider Inquiries — Pregnancy Risk Assessment Monitoring System, United States, 2021
Weekly / May 2, 2024 / 73(17);393–398

Cigarette smoking during pregnancy increases the risk for pregnancy complications and adverse infant outcomes such as preterm delivery, restricted fetal growth, and infant death. Health care provider counseling can support smoking cessation. Data from the 2021 Pregnancy Risk Assessment Monitoring System were analyzed to estimate the prevalence of smoking before, during, and after pregnancy; quitting smoking during pregnancy; and whether health care providers asked about cigarette smoking before, during, and after pregnancy among women with a recent live birth. In 2021, the prevalence of cigarette smoking was 12.1% before pregnancy, 5.4% during pregnancy, and 7.2% during the postpartum period; 56.1% of women who smoked before pregnancy quit smoking while pregnant. Jurisdiction-specific prevalences of smoking ranged from 3.5% to 20.2% before pregnancy, 0.4% to 11.0% during pregnancy, and 1.0% to 15.1% during the postpartum period. Among women with a health care visit during the associated period, the percentage of women who reported that a health care provider asked about smoking was 73.7% at any health care visit before pregnancy, 93.7% at any prenatal care visit, and 57.3% at a postpartum checkup. Routine assessment of smoking behaviors among pregnant and postpartum women can guide the development and implementation of evidence-based tobacco control measures at the jurisdiction and health care–system level to reduce smoking among pregnant and postpartum women.

Key points: 

• Three in 5 pregnant women were asked about their smoking status at their postpartum checkup.
• One in 20 women in 2021 reported smoking during pregnancy, and more than half quit during pregnancy.
• One in 13 women reported smoking after delivery.
• Almost all women were asked about smoking at prenatal visits.
• Clinicians are encouraged to routinely discuss smoking with pregnant and postpartum patients and counsel them about resources to help them quit.