Smoking and pregnancy outcomes among young adult women in a nationally representative longitudinal panel study

The negative effect of smoking on pregnancy outcomes is fairly well understood, but many of the selection mechanisms related to poor birth outcomes are likely to be correlated with other factors. For example, a young mother's own exposure to smoking as a child, poor health status, lack of access to health care, and use of other psychoactive substances also lead to poor outcomes. It is the contribution of these factors in combination with prenatal smoking that we specify. Further, we investigate the lag structure of smoking prevention and smoking cessation programs on poor birth outcomes. Although a large literature investigates the effects of targeted smoking intervention programs, less is known about the effects of earlier general smoking prevention efforts on later smoking behavior. We use the National Longitudinal Study of Adolescent Health (Add Health) to investigate the following questions: How does a young woman's experience with smoking and smoking cessation interventions affect her propensity to smoke during pregnancy? How does smoking among young women affect their pregnancy outcomes, particularly with respect to preterm delivery, low birth weight, infant mortality, and poor child health? The longitudinal, population-based nature of Add Health makes it an appropriate data set to answer these questions.