Reproductive Health

Tobacco Use and Pregnancy: Publications

Surgeon General’s Reports

2010 Surgeon General’s Report: How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease
This report describes in detail the specific pathways by which tobacco smoke damages the human body, including reproductive and developmental effects.

2006 Surgeon General’s Report on the Health Consequences of Involuntary Exposure to Tobacco Smoke
Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke. Pregnant women who are exposed to secondhand smoke have 20 percent higher odds of giving birth to a low birth weight baby than women who are not exposed to secondhand smoke during pregnancy. Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, and more severe asthma.

2004 Surgeon General’s Report: Smoking Harms Reproduction
Smoking harms every phase of reproduction. Women who smoke have more difficulty becoming pregnant and have a higher risk of never becoming pregnant.

2001 Surgeon General’s Report: Women and Smoking
This 2001 report summarizes what is now known about smoking among women, including patterns and trends in smoking habits, factors associated with starting to smoke and continuing to smoke, the consequences of smoking on women’s health, and interventions for cessation and prevention.

Peer–Reviewed Publications

The following is a list of related publications on tobacco use and pregnancy authored by CDC's Division of Reproductive Health and collaborators. These publications are only a few of the scientific and technical materials available. We recommend that you review abstracts of our reports and other publications by using the resources of the National Library of Medicine's PubMed service. PubMed is a searchable database that provides abstracts of biomedical articles and reports. You may also be able to obtain full text articles (some services may require subscriptions to view full text articles). If you are seeking less technical information, please use the National Library of Medicine's MedlinePlus, which offers a wide range of information on diseases, disorders, treatments, drugs, and preventive services.

Surveillance and Epidemiology

Dietz, PM, Burley K, England LJ, Homa D, Tong V, Dube S, Bernert JT. U.S. estimates of nondisclosure of cigarette smoking among pregnant and nonpregnant women of reproductive age in the United States. Am J Epidemiol. 2011;173(3):355–359. Available at Pubmed.

Bombard J, Dietz PM, Galavotti C, England LJ, Tong VT, Hayes D, Morrow B. Chronic diseases and related risk factors among low-income women who recently delivered a live birth. Matern Child Health J. 2010 Dec 14. Available at Pubmed.

Dietz PM, England LJ, Shapiro-Mendoza CK, Tong VT, Farr SL, Callaghan WM. Infant morbidity and mortality attributable to prenatal smoking in the United States Am J Prev Med. 2010;39(1):45–52. Available at Pubmed.

Tong VT, Dietz PM, England LJ. Reliance on self-reporting underestimates pregnancy smoking rates in Scotland, with more than 2400 pregnant smokers estimated to be missed each year. Evid Based Med. 2010;15(3):94–95. Available at Pubmed.

Kim SY, England L, Dietz PM, Morrow B, Perham-Hester KA. Patterns of cigarette and smokeless tobacco use before, during, and after pregnancy among Alaska native and white women in Alaska, 2000–2003. Matern Child Health J. 2010;14(3):365–372. Available at Pubmed.

Tong VT, Jones JR, Dietz PM, D'Angelo D, Bombard JM. Trends in smoking before, during, and after pregnancy—Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 31 sites, 2000–2005. MMWR Surveill Summ. 2009 29;58(4):1–29.

Kim SY, England L, Dietz PM, Morrow B, Perham-Hester KA. Prenatal cigarette smoking and smokeless tobacco use among Alaska Native and white women in Alaska, 1996–2003. Matern Child Health J. 2009;13(5):652–9. Available at Pubmed.

Kim SY, England LJ, Kendrick JS, Dietz PM, Callaghan WM. The contribution of clinic-based interventions to reduce prenatal smoking prevalence among US women. Am J Public Health. 2009;99(5):893–898. Available at Pubmed.

Allen AM, Prince CB, Dietz PM. Postpartum depressive symptoms and smoking relapse. Am J Prev Med. 2009;36(1):9–12. Available at Pubmed.

Sharma AJ, Cogswell ME, Li R. Dose-response associations between maternal smoking during pregnancy and subsequent childhood obesity: effect modification by maternal race/ethnicity in a low-income U.S. cohort. Am J Epidemiol. 2008 ;168(9):995–1007. Available at Pubmed.

Allen AM, Dietz PM, Tong VT, England LJ, Prince CB. Prenatal smoking prevalence ascertained from two population-based data sources: birth certificates and PRAMS questionnaires, 2004. Public Health Rep. 2008;123(5):586–592. Available at Pubmed.

Tong VT, England LJ, Dietz PM, Asare LA. Smoking patterns and use of cessation interventions during pregnancy. Am J Prev Med. 2008;35(4):327–333. Available at Pubmed.

Adams KE, Melvin CL, Raskind-Hood CL. Sociodemographic, insurance, and risk profiles of maternal smokers post the 1990s: how can we reach them? Nicotine Tob Res. 2008;10(7):1121–1129. Available at Pubmed.

England LJ, Grauman A, Qian C, Wilkins DG, Schisterman EF, Yu KF, Levine RJ. Misclassification of maternal smoking status and its effects on an epidemiologic study of pregnancy outcomes. Nicotine Tob Res. 2007;1–9. Available at Pubmed.

England L, Zhang J. Smoking and risk of preeclampsia: a systematic review. Front Biosc.i 2007;1(12):2471–2483. Available at Pubmed.

England LJ, Kendrick JS, Wilson HG, Merritt RK, Gargiullo PM, Zahniser SC. Effects of smoking reduction during pregnancy on the birth weight of term infants. Am J Epidemiol. 2001;154(8):694–701. Available at Pubmed.

England LJ, Kendrick JS, Gargiullo PM, Zahniser SC, Hannon WH. Measures of maternal tobacco exposure and infant birth weight at term. Am J Epidemiol. 2001;153(10):954–960. Available at Pubmed.

Dietz PM, Adams MM, Kendrick JS, Mathis MP. Completeness of ascertainment of prenatal smoking using birth certificates and confidential questionnaires: variations by maternal attributes and infant birth weight. PRAMS Working Group. Pregnancy Risk Assessment Monitoring System. Am J Epidemiol. 1998;148(11):1048–1054. Available at Pubmed.

Dietz PM, Adams MM, Rochat RW, Mathis MP. Prenatal smoking in two consecutive pregnancies: Georgia, 1989–1992. Matern Child Health J. 1997 Mar;1(1):43–51. Erratum in: Matern Child Health J. 1997;(3):201. Available at Pubmed.

Kendrick JS, Zahniser SC, Miller N, Salas N, Stine J, Gargiullo PM, Floyd RL, Spierto FW, Sexton M, Metzger RW, et al. Integrating smoking cessation into routine public prenatal care: the Smoking Cessation in Pregnancy project. Am J Public Health. 1995;85(2):217–222. Available at Pubmed.

Birth Defects

Alverson CJ, Strickland MJ, Gilboa SM, Correa A. Maternal Smoking and Congenital Heart Defects in the Baltimore-Washington Infant Study. Pediatrics. 2011;127(3):e647–653. Available at Pubmed.

MacLehose RF, Olshan AF, Herring AH, Honein MA, Shaw GM, Romitti PA. National Birth Defects Prevention Study—Bayesian methods for correcting misclassification: an example from birth defects epidemiology. Epidemiology 2009;20(1):27–35. Available at Pubmed.

Miller EA, Manning SE, Rasmussen SA, Reefhuis J, Honein MA; National Birth Defects Prevention Study. Maternal exposure to tobacco smoke, alcohol and caffeine, and risk of anorectal atresia: National Birth Defects Prevention Study 1997–2003. Paediatr Perinat Epidemiol. 2009;23(1):9–17. Available at Pubmed.

Malik S, Cleves MA, Honein MA, Romitti PA, Botto LD, Yang S, Hobbs CA; National Birth Defects Prevention Study. Maternal smoking and congenital heart defects. Pediatrics 2008;121(4):e810–816. Available at Pubmed.

Honein MA, Rasmussen SA, Reefhuis J, Romitti PA, Lammer EJ, Sun L, Correa A. Maternal smoking and environmental tobacco smoke exposure and the risk of orofacial clefts. Epidemiology 2007;18(2):226–233. Available at Pubmed.

Smokeless Tobacco

England LJ, Kim SY, Tomar SL, Ray CS, Gupta PC, Eissenberg T, Cnattingius S, Bernert JT, Tita AT, Winn DM, Djordjevic MV, Lambe M, Stamilio D, Chipato T, Tolosa JE. Non-cigarette tobacco use among women and adverse pregnancy outcomes. Acta Obstet Gynecol Scand. 2010;89(4):454–464. Available at Pubmed.

Kim SY, England L, Dietz PM, Morrow B, Perham-Hester KA. Prenatal Cigarette Smoking and Smokeless Tobacco Use Among Alaska Native and White Women in Alaska, 1996–2003. Matern Child Health J. 2009;13(5):652–659. Available at Pubmed.

Economic Costs

Adams EK, Melvin CL, Raskind-Hood C, Joski PJ, Galactionova E. Infant delivery costs related to maternal smoking: an update. Nicotine Tob Res. 2011;13(8):627-37. Available at Pubmed.

Ayadi MF, Adams EK, Melvin CL, Rivera CC, Gaffney CA, Pike J, Rabius V, Ferguson JN. Costs of a smoking cessation counseling intervention for pregnant women: comparison of three settings. Public Health Rep. 2006;21(2);120–126. Available at Pubmed.

Adams EK, Alao Melvin, Rivera CC. Smoking among medicaid insured mothers: what are the neonatal expenses? Health Care Financing Review 2005;26(2).

Adams EK, Miller VP, Ernst C, Nishimura BK, Melvin C, Merritt R. Neonatal health care costs related to smoking during pregnancy. Health Econ. 2002;11(3):193–206. Available at Pubmed.

Melvin CL, Adams EK, Miller V. Costs of smoking during pregnancy: development of the maternal and child health smoking attributable mortality, morbidity and economic costs (MCHSAMMEC) software. Tob Control. 2000;9 Suppl 3:III12–5. Available at Pubmed.

Adams EK, Melvin CL. Costs of maternal conditions attributable to smoking during pregnancy. Am J Prev Med. 1998 ;15(3):212–9. Available at Pubmed.

Global Tobacco Use and Exposure During Pregnancy

Bloch M, Tong VT, Novotny TE, England LJ, Dietz PM, Kim SY, Samet JM, Tolosa JE. Tobacco use and secondhand smoke exposure among pregnant women in low- and middle-income countries: a call to action. Acta Obstet Gynecol Scand. 2010;89(4):418–422. Available at Pubmed.

Oncken CA, Dietz PM, Tong VT, Belizán JM, Tolosa JE, Berghella V, Goldenberg RL, Lando HA, Samet JM, Bloch MH. Prenatal tobacco prevention and cessation interventions for women in low- and middle-income countries. Acta Obstet Gynecol Scand. 2010;89(4):442-453. Available at Pubmed.

CDC publications highlighting tobacco and pregnancy data.