What is CDC doing to reduce tobacco use during the reproductive years?

Since 1987, CDC's Division of Reproductive Health (DRH) has conducted research and surveillance on tobacco use and pregnancy. DRH collaborates with researchers from CDC's Office on Smoking and Health, National Center for Environmental Health, and the National Center for Birth Defects and Disabilities. The following are highlights of CDC’s work currently being conducted to address this public health problem.

Multiple analyses of Pregnancy Risk Assessment and Monitoring System data
(PRAMS), the Pregnancy Risk Assessment Monitoring System, is a CDC and state health department surveillance project. PRAMS collects state–specific, population–based data on maternal attitudes and experiences before, during, and shortly after pregnancy. Currently, PRAMS covers 80% of all U.S. live births in 37 states, New York City, and the South Dakota Tribal–State collaborative project. PRAMS includes information on tobacco use, smoking cessation, and smoking rules that may have an impact on infant and maternal outcomes.

Smokeless tobacco use in Alaska
Smokeless tobacco use, including commercial chew and iqmik (a homemade smokeless tobacco product mixed with ash), is highly prevalent among Alaska Natives. The ash increases the amount of free nicotine available for absorption, potentially making this product more addictive than commercial products. In some areas, smokeless tobacco use exceeds 60% among pregnant women. Little is known about potential adverse effects of smokeless tobacco on women and infants. A number of studies are being conducted to understand this unique problem on pregnancy. The results of these studies will be used to develop public health messages for Alaska Natives.

Health and economic consequences of prenatal smoking
The health effects of prenatal smoking on the mother and infant are well known. Previous estimates of the smoking attributable neonatal costs exceed $350 million nationally more than $700 per mother (1996 dollars). Maternal and Child Health SAMMEC (Smoking Attributable Mortality, Morbidity, and Economic Costs) can be used to estimate the disease impact of smoking among pregnant women in the United States, individual states, and other large populations. The disease impact of smoking refers to the health and health–related economic consequences of smoking, including smoking–attributable infant deaths, and excess health care expenditures. These measures help public health researchers and policymakers quantify the adverse effects of cigarette smoking. CDC is currently updating the smoking attributable costs based on 2001/2002 Pregnancy Risk Assessment Monitoring System (PRAMS) data and 2003 state birth certificates.

Cooperative Agreement with Association of Maternal and Child Health Programs (AMCHP)
CDC supports a cooperative agreement with the Association of Maternal and Child Health Programs (AMCHP)* to support prenatal smoking cessation programs in states. AMCHP’s members consist of all State Maternal and Child Health (MCH) program directors and their staff. AMCHP is partnering with the American College of Obstetricians and Gynecologists (ACOG)* and the Planned Parenthood Federation of America (PPFA)* to strengthen knowledge, partnerships, and capacity among state MCH and tobacco professionals, OB–GYNs, and community clinicians on effective tobacco programs for women of reproductive age.

Page last reviewed: 2/19/08
Page last modified: 6/6/07
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion