Journal of Community Health

, Volume 38, Issue 5, pp 838–846 | Cite as

Estimating the Impact of Smoking Cessation During Pregnancy: The San Bernardino County Experience

  • Michael Batech
  • Serena Tonstad
  • Jayakaran S. Job
  • Richard Chinnock
  • Bryan Oshiro
  • T. Allen Merritt
  • Gretchen Page
  • Pramil N. Singh
Original Paper


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.


San 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).


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Michael Batech
    • 1
    • 7
  • Serena Tonstad
    • 2
  • Jayakaran S. Job
    • 3
  • Richard Chinnock
    • 4
  • Bryan Oshiro
    • 5
  • T. Allen Merritt
    • 6
  • Gretchen Page
    • 8
  • Pramil N. Singh
    • 1
    • 7
  1. 1.Loma Linda University School of Public HealthLoma LindaUSA
  2. 2.Department of Health Promotion and EducationLoma Linda University School of Public HealthLoma LindaUSA
  3. 3.Department of Global HealthLoma Linda University School of Public HealthLoma LindaUSA
  4. 4.Department of PediatricsLoma Linda University Medical CenterLoma LindaUSA
  5. 5.Department of Gynecology and ObstetricsLoma Linda University Medical CenterLoma LindaUSA
  6. 6.Department of PediatricsLoma Linda University School of MedicineLoma LindaUSA
  7. 7.Loma Linda University Center for Health ResearchLoma LindaUSA
  8. 8.Southern Inland Counties Regional Perinatal ProgramLoma Linda University Medical CenterLoma LindaUSA

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