Trends in modification of smoking behaviors among pregnant women in West Virginia

Background: Rates of smoking among pregnant women in West Virginia are higher than national prenatal smoking rates. Recent research in the state points to the benefits of smoking reduction in a clinical study of infant birth outcomes. The purpose of the current study is to examine 6-year trends in prenatal smoking patterns and identify factors associated with reduced smoking among a representative sample of pregnant women.

Method: Secondary data analysis was conducted using de-identified weighted PRAMS 2005-2010 data from West Virginia. The primary outcome of interest was favorable change in prenatal smoking behavior defined as either quitting or reducing smoking in pregnancy.

Results: No significant difference was found in the proportion of favorable change over the 6-year period. Adjusted multivariable analysis results demonstrate that the odds of favorable change in smoking behavior among pregnant women is higher if they are younger (<35 years of age) (OR 1.96; 95% CI 1.28-3.00; p<0.01), primiparous (OR 2.27; 95% CI 1.75-2.96; p<0.001), or have a higher level of education beyond high school (OR 1.88; 95% CI 1.37-2.57; p<0.001). 

Conclusion: The current population-based study identified factors that contribute to women’s likelihood of quitting or reducing smoking in pregnancy in West Virginia, where prenatal smoking rates are the highest in the nation and where there is limited success in reducing prenatal smoking exposure over time. Health care providers and policy makers should consider these factors in developing approaches to promote smoking cessation and reduction among pregnant women in the state thereby reducing prenatal smoking exposure.