Smoking Cessation

Health and economic benefits are substantial when pregnant women stop smoking

Maternal smoking during pregnancy contributed to up to one-fourth of the low birthweight (LBW) infants born in the United States in the 1980s. These infants are more apt to be admitted to neonatal intensive care units, are more susceptible to illnesses such as respiratory infections, and generally require more expensive care than normal birthweight infants. Excess direct medical costs per live birth for each pregnant smoker (in 1995 dollars) was $511, and the total cost was $263 million. However, a new study shows that reducing smoking prevalence by just 1 percentage point would prevent 1,300 low birthweight live births and save $21 million in direct medical costs in the first year. Over 7 years, it would prevent 57,200 low birthweight infants and save $572 million in direct medical costs.

These figures don't even include other direct costs, such as childhood respiratory illness because of secondhand smoke exposure postnatally, or indirect costs, such as loss of life because of sudden infant death syndrome associated with maternal smoking and treatment or long-term rehabilitation of LBW infants. The study was conducted by the Patient Outcomes Research Team (PORT) for the Prevention of Low Birth Weight in High-Risk and Minority Women and was supported in part by the Agency for Healthcare Research and Quality (PORT contract 290-92-0055).

The researchers used simulations based on data on neonatal costs per live birth to calculate excess direct medical costs for each LBW infant and savings associated with a drop in smoking by pregnant women. The cost estimates for LBW were based on a large population database representing 85 percent of all live births in California after widespread use of surfactants to reduce respiratory problems in LBW newborns.

For more details, see "Short-term health and economic benefits of smoking cessation: Low birth weight," by James M. Lightwood, Ph.D., Ciaran S. Phibbs, Ph.D., and Stanton A. Glantz, Ph.D., in the December 1999 Pediatrics 104(6), pp. 1312-1320.

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