Exploring Transitions in Prenatal Maternal Tobacco Use: Evidence from the PRAMS Data

Additional Authors

Manik Ahuja, PhD, Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN. Jewel B. Thomas, Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN. Samaria Ejiogu, MSc, Department of Economics, College of Business Administration, University of Nebraska, Omaha, Nebraska. Shanice K. Douglas B.Ed,. Department of Mathematics and Statistics, School of Science, Engineering and Math, East Tennessee State University, Johnson City TN. Hadii M. Mamudu, PhD, Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN.

Abstract

Tobacco use remains a leading cause of preventable morbidity and mortality, with smoking during pregnancy posing significant risks to the mother, fetus, and child. Limited research exists on transitions in tobacco use during pregnancy. This study aims to identify factors associated with behavioral shifts, including transitions from exclusive cigarette smoking to dual use or from non-smoking to smoking or e-cigarette use. This study utilized national data from Phase 8 of the Pregnancy Risk Assessment Monitoring System (PRAMS) (2016–2021; N=216,035). Descriptive statistics and multivariable logistic regression analyses examined sociodemographic, health system, and geographic factors influencing transitions in tobacco use behaviors among pregnant women. No smoking to smoking during the last three months of pregnancy was 85.% less likely (OR: 0.15, 95% CI: 0.00-0.55, P<0.01) among individuals with a 4-year degree and 55% less likely (OR: 0.45, 95% CI: 0.25-0.80, P<0.01) among married women. Smoking 3 months before pregnancy to only e-cigarette use last 3 months of pregnancy was 81% less likely (OR: 0.19, 95% CI: 0.07-0.49, P<0.001) among those with a 4-year degree and 64% less likely (OR: 0.36, 95% CI: 0.22-0.60, P<0.0001) among married women. Smoking 3 months before pregnancy to dual smoking and e-cigarette use last 3 months of pregnancy was 63% less likely (OR: 0.370, 95% CI: 0.183-0.749, P<0.0057) among those with a 4-year degree and 52% less likely (OR: 0.48, 95% CI: 0.34-0.67, P<0.0001 among married women. Mono smoking or e-cigarette use 3 months before pregnancy to dual smoking and e-cigarette use last 3 months of pregnancy was 65.9% less likely (OR: 0.34, 95% CI: 0.17-0.69, P<0.01) among those with a 4-year degree and 50% less likely (OR: 0.50, 95% CI: 0.36-0.70, P<0.0001) among married women. These confirm that higher income and ethnicity are protective factors against smoking. Alcohol use and unintended pregnancy increase risk.

Start Time

16-4-2025 9:00 AM

End Time

16-4-2025 11:30 AM

Presentation Type

Poster

Presentation Category

Health

Student Type

Graduate Student - Masters

Faculty Mentor

Shimin Zheng

Faculty Department

Biostatistics and Epidemiology

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Apr 16th, 9:00 AM Apr 16th, 11:30 AM

Exploring Transitions in Prenatal Maternal Tobacco Use: Evidence from the PRAMS Data

Tobacco use remains a leading cause of preventable morbidity and mortality, with smoking during pregnancy posing significant risks to the mother, fetus, and child. Limited research exists on transitions in tobacco use during pregnancy. This study aims to identify factors associated with behavioral shifts, including transitions from exclusive cigarette smoking to dual use or from non-smoking to smoking or e-cigarette use. This study utilized national data from Phase 8 of the Pregnancy Risk Assessment Monitoring System (PRAMS) (2016–2021; N=216,035). Descriptive statistics and multivariable logistic regression analyses examined sociodemographic, health system, and geographic factors influencing transitions in tobacco use behaviors among pregnant women. No smoking to smoking during the last three months of pregnancy was 85.% less likely (OR: 0.15, 95% CI: 0.00-0.55, P<0.01) among individuals with a 4-year degree and 55% less likely (OR: 0.45, 95% CI: 0.25-0.80, P<0.01) among married women. Smoking 3 months before pregnancy to only e-cigarette use last 3 months of pregnancy was 81% less likely (OR: 0.19, 95% CI: 0.07-0.49, P<0.001) among those with a 4-year degree and 64% less likely (OR: 0.36, 95% CI: 0.22-0.60, P<0.0001) among married women. Smoking 3 months before pregnancy to dual smoking and e-cigarette use last 3 months of pregnancy was 63% less likely (OR: 0.370, 95% CI: 0.183-0.749, P<0.0057) among those with a 4-year degree and 52% less likely (OR: 0.48, 95% CI: 0.34-0.67, P<0.0001 among married women. Mono smoking or e-cigarette use 3 months before pregnancy to dual smoking and e-cigarette use last 3 months of pregnancy was 65.9% less likely (OR: 0.34, 95% CI: 0.17-0.69, P<0.01) among those with a 4-year degree and 50% less likely (OR: 0.50, 95% CI: 0.36-0.70, P<0.0001) among married women. These confirm that higher income and ethnicity are protective factors against smoking. Alcohol use and unintended pregnancy increase risk.