Smoking rates among pregnant women in Tennessee, 1990-2001

Prev Med. 2006 Sep;43(3):196-9. doi: 10.1016/j.ypmed.2006.04.021. Epub 2006 Jun 15.


Background: Pregnant smokers represent a major public health challenge. The objective of this study was to determine trends in smoking during pregnancy in Tennessee, a state with one of the highest smoking burdens in the nation, and to confirm characteristics of high-risk groups to target for smoking prevention.

Methods: Population-based cohort study of pregnant women in Tennessee who delivered live births from 1990-2001. Trends in smoking were determined by maternal age, race and insurance status using vital records and Medicaid data. Characteristics of women who smoked during pregnancy were described for 2001.

Results: Among 900,986 pregnant women in the cohort, there were statewide decreases in smoking rates during pregnancy; however, smoking among pregnant women younger than 25 years in Medicaid increased from 1996 to 2001: among whites from 31% to 34%, and among blacks from 6% to 9% (P values for trend shifts <0.0001). Characteristics of pregnant women who smoked during pregnancy included white race, Medicaid enrollment, nonurban residence, and less than a high school education.

Conclusions: Smoking rates increased significantly among pregnant women <25 years enrolled in Medicaid between 1996 and 2001. Tennessee needs smoking cessation and prevention efforts that target young, low-income women with less than a high school education.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Birth Certificates
  • Blacks
  • Cohort Studies
  • Data Collection
  • Educational Status
  • Female
  • Humans
  • Medicaid
  • Pregnancy
  • Smoking / epidemiology*
  • Smoking / trends
  • Smoking Prevention
  • Tennessee / epidemiology
  • Whites