Estimating the Impact of Smoking Cessation During Pregnancy: The San Bernardino County Experience
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We examined the relation between maternal smoking and adverse infant outcomes [low birth weight (LBW), and preterm birth (PTB)] during 2007–2008 in San Bernardino County, California—the largest county in the contiguous United States which has one of the highest rates of infant mortality in California. Using birth certificate data, we identified 1,430 mothers in 2007 and 1,355 in 2008 who smoked during pregnancy. We assessed the effect of never smoking and smoking cessation during pregnancy relative to smoking during pregnancy for the 1,843/1,798 LBW, and 3,480/3,238 PTB’s recorded for 2007/2008, respectively. To describe the effect of quitting smoking during pregnancy, we calculated the exposure impact number for smoking during pregnancy. Major findings are: (1) relative to smoking during pregnancy, significantly lower risk of LBW among never smoking mothers [OR, year: 0.56, 2007; 0.54, 2008] and for smoking cessation during pregnancy [0.57, 2007; 0.72, 2008]; (2) relative to smoking during pregnancy, significantly lower risk of PTB was found for never smoking mothers [0.68, 2007; 0.68, 2008] and for smoking cessation during pregnancy [0.69, 2007; 0.69, 2008]; (3) an exposure impact assessment indicating each LBW or PTB outcome in the county could have been prevented either by at least 35 mothers quitting smoking during pregnancy or by 25 mothers being never smokers during pre-pregnancy. Our findings identify an important burden of adverse infant outcomes due to maternal smoking in San Bernardino County that can be effectively decreased by maternal smoking cessation.
KeywordsSan Bernardino County Maternal tobacco use Smoking cessation during pregnancy Exposure impact number
This study was supported by Grant HHSN267200700021C from NICHD/Department of Health and Human Services (National Children’s Study Award to University of California, Irvine, and sub-award to Loma Linda University and Cal State San Bernardino).
- 1.Culyer, A. J., & Newhouse, J. P. (2000). Handbook of health economics (1st ed.). Amsterdam, New York: Elsevier.Google Scholar
- 3.(2001) Women and smoking: A report of the surgeon general. Atlanta (GA).Google Scholar
- 4.Centers for Disease, Control, and Prevention. (2008). Smoking prevalence among women of reproductive age—United States, 2006. Morbidity and Mortality Weekly Report, 57(31), 849–852.Google Scholar
- 5.The 2004 United States surgeon general’s report: The health consequences of smoking. (2004). N S W Public Health Bull, 15(5–6):107.Google Scholar
- 6.Osterman, M. J., Martin, J. A., Mathews, T. J., & Hamilton, B. E. (2011). Expanded data from the new birth certificate, 2008. National Vital Statistics Reports, 59(7), 1–28.Google Scholar
- 7.Martin, J. A., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Mathews, T. J., & Osterman, M. J. (2010). Births: Final data for 2008. National Vital Statistics Reports, 59(1), 3–71.Google Scholar
- 8.Institute, University of Wisconsin Population Health. (2012). County health rankings 2012. Google Scholar
- 9.Vital Statistics Query System. State of California, Department of Public Health, Birth and Death Records. (2010). http://www.apps.cdph.ca.gov/vsq/screen_idra.asp?cnty_cd=36&Year_Data=2009&Stats=4.
- 10.CDPH. (2009). Vital statistics query system. Retrieved 16 July 2012 from http://www.applications.dhs.ca.gov/vsq/default.asp.
- 11.Knox, N. (2008). Foreclosures plague san bernardino county, calif., USA TODAY. Retrieved from http://www.usatoday.com/money/economy/housing/closetohome/2008-01-28-san-bernardino_N.htm.
- 12.Willon, P. (2012, July 25, 2012). Bankrupt san bernardino must cut spending by a third, Los Angeles Times. Retrieved from http://www.latimes.com/news/local/la-me-san-bernardino-cuts-20120726,0,397850.story.
- 13.Shimura, T. (2012). County unemployment rate increases despite job growth, High Desert Daily Press. Retrieved from http://www.vvdailypress.com/news/jobs-35672-rate-added.html.
- 21.Hack, M., Taylor, H. G., Drotar, D., et al. (2005). Chronic conditions, functional limitations, and special health care needs of school-aged children born with extremely low-birth-weight in the 1990s. Journal of the American Medical Association, 294(3), 318–325. doi: 10.1001/jama.294.3.318.PubMedCrossRefGoogle Scholar