Tobacco Use in Pregnancy: A Place-Based Perspective

Additional Authors

Dr. Hadii Mamudu -Department of Health Services Management and Policy, College of Public Health, East Tennessee State University -Center for Cardiovascular Risk Research, East Tennessee State University Dr. Ingrid Luffman -Department of Geosciences, College of Arts and Sciences -Spatial Epidemiology and Medical Geography Lab, East Tennessee State University

Abstract

Despite the well-established knowledge of the adverse effects of tobacco use and second-hand smoke exposure on the mother and the fetus, a significant number of pregnant women continue to use tobacco products in the U.S. This study examined geographic disparities and inequities in tobacco use among pregnant women in Tobacco Nation States, Appalachian states, and rural regions. To assess tobacco use, national data from the Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed. The study sample included mothers from Phase 8 of the PRAMS dataset (2016-2021) in U.S. states with ≥50% response rates (N=221,381). All analyses were performed using SAS software. Weighted tobacco use prevalence was calculated using descriptive statistics, and multivariable logistic regression was used to identify factors associated with tobacco use outcomes. In Tobacco Nation states, 11.2% of respondents reported tobacco use during pregnancy compared to 6.1% in non-Tobacco Nation states. Similarly, in Appalachian states, 8.1% of pregnant women reported using tobacco, compared to 6.8% in non-Appalachian states. Pregnant women in rural communities reported a tobacco use rate of 14.0%, which is more than twice the 6.0% reported in urban areas. These findings highlight persistent disparities and inequities linked to geography and rurality in these regions. To reduce these disparities, comprehensive tobacco control policies and provider-level interventions should be prioritized. Closing these gaps could improve both maternal and fetal outcomes.

Start Time

16-4-2025 9:00 AM

End Time

16-4-2025 11:30 AM

Presentation Type

Poster

Presentation Category

Health

Student Type

Clinical Doctoral Student (e.g., medical student, pharmacy student)

Faculty Mentor

Emily Flores

Faculty Department

Pharmacy Practice

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

Tobacco Use in Pregnancy: A Place-Based Perspective

Despite the well-established knowledge of the adverse effects of tobacco use and second-hand smoke exposure on the mother and the fetus, a significant number of pregnant women continue to use tobacco products in the U.S. This study examined geographic disparities and inequities in tobacco use among pregnant women in Tobacco Nation States, Appalachian states, and rural regions. To assess tobacco use, national data from the Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed. The study sample included mothers from Phase 8 of the PRAMS dataset (2016-2021) in U.S. states with ≥50% response rates (N=221,381). All analyses were performed using SAS software. Weighted tobacco use prevalence was calculated using descriptive statistics, and multivariable logistic regression was used to identify factors associated with tobacco use outcomes. In Tobacco Nation states, 11.2% of respondents reported tobacco use during pregnancy compared to 6.1% in non-Tobacco Nation states. Similarly, in Appalachian states, 8.1% of pregnant women reported using tobacco, compared to 6.8% in non-Appalachian states. Pregnant women in rural communities reported a tobacco use rate of 14.0%, which is more than twice the 6.0% reported in urban areas. These findings highlight persistent disparities and inequities linked to geography and rurality in these regions. To reduce these disparities, comprehensive tobacco control policies and provider-level interventions should be prioritized. Closing these gaps could improve both maternal and fetal outcomes.