Smoking Prevalence and Cessation Before and During Pregnancy: Data From the Birth Certificate, 2014.

OBJECTIVES: This report presents findings for 2014 on maternal smoking prevalence and cessation before and during pregnancy as collected on the 2003 U.S. Standard Certificate of Live Birth, for a 46-state and District of Columbia reporting area, representing 95% of all births in the United States.

METHODS: Cigarette smoking and cessation rates 3 months before and during pregnancy are presented by maternal age; race and ethnicity; marital status; educational attainment; source of payment at delivery (private insurance, Medicaid, and self-pay); receipt of benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children; prenatal care initiation; and jurisdiction.

RESULTS: About 1 in 10 women who gave birth in 2014 smoked during the 3 months before pregnancy (10.9%), and about one-quarter of these women (24.2%) did not smoke during pregnancy (i.e., quit before pregnancy). The smoking rate at any time during pregnancy was 8.4%, with 20.6% of women who smoked in the first or second trimesters quitting by the third trimester. Smoking during pregnancy was more prevalent for women aged 20–24 (13.0%) than for other ages, and by race and Hispanic origin, the highest rate was for non- Hispanic American Indian or Alaska Native women (18.0%). Smoking during pregnancy ranged from 1.8% in California to 27.1% in West Virginia. The highest smoking cessation rates before and during pregnancy were for women with the highest educational attainment, private insurance, and non-Hispanic Asian and Hispanic race and ethnicity. On average, women who continued to smoke during pregnancy smoked fewer cigarettes as the pregnancy progressed, from 13 per day before pregnancy to 9 per day by the third trimester.