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Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
Tel: 1-800-CDC-INFO
(1-800-232-4636)
TTY: 1-888-232-6348
E-mail: tobaccoinfo@cdc.gov
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Morbidity and Mortality Weekly Reports (MMWRs)
State Estimates of Neonatal Health-Care Costs Associated with Maternal Smoking
—United States, 1996
October 7, 2004 / Vol. 53 / No. 39
MMWR Highlights
- The Maternal and Child Health Smoking-Attributable Mortality,
Morbidity, and Economic Costs (MCH SAMMEC) software provided a national
estimate of smoking-attributable neonatal expenditures of $366 million
in 1996, or $704 per maternal smoker.
- Across areas, higher total SAE estimates by MCH SAMMEC were
associated with higher numbers of births and higher smoking prevalence.
SAE totals ranged from $34 million in California to $537,661 in the
District of Columbia (DC).
- After California, states with the highest SAEs were New York, Ohio,
Pennsylvania, and Texas; states with the lowest SAEs were Alaska,
Hawaii, Vermont, and Wyoming.
- Although overall prevalence of maternal smoking was 13.2% in 1997,
prevalence by area ranged from 4.8% in New York City to 25.3% in West
Virginia (4).
- To focus on the population at risk for excess costs in and across
areas, SAEs per maternal smoker were estimated. SAEs per maternal smoker
ranged from $519 in Hawaii to $1,334 in DC.
- Although higher smoking prevalence usually is associated with white
mothers as compared with blacks, smoking prevalence was higher among
black mothers in 13 states and DC. Among black mothers in these 13
states, smoking prevalence ranged from 6.7% to 21.3%, and SAE per
maternal smoker ranged from $1,008 to $1,403.
- Among all states, the average SAE for black mothers was almost
double that for white mothers ($1,207 versus $651). However, adverse
outcomes among black infants are more likely regardless of maternal
smoking; at least one study suggests stronger effects of smoking on
birthweight among black women compared with white women.
- In every area except DC, Indiana, and Mississippi, smoking
prevalence was higher for women aged <20 years than for women aged >20
years. In all areas, the prevalence of smoking among pregnant women with
less education was more than double the prevalence of women with more
education.
- Persons who were uninsured or who were on Medicaid while pregnant
had greater smoking prevalence than those with private or other health
insurance. In all areas except DC and Texas, the prevalence of smoking
among Medicaid/uninsured mothers was >10%; prevalence was highest in
Indiana (37.7%).
- The highest SAE per maternal smoker among the Medicaid/uninsured
group was in DC ($1,355); the lowest was in Hawaii ($523).
- Among women in the private/other insurance group, smoking prevalence
was <10% in 28 states. The average SAEs per maternal smoker, from all
areas, were $753 for those in the Medicaid/uninsured group and $626 for
those in the private/other insurance group.
- Mothers who are on Medicaid or uninsured are less likely to initiate
prenatal care in the first trimester.
- Both the prevalence of maternal smoking and SAE per maternal smoker
were higher for mothers who began prenatal care in the third trimester
or who had no prenatal care, compared with mothers who received prenatal
care in the first or second trimester.
- The average SAEs per maternal smoker ranged from $485 in Hawaii to
$1,112 in DC for mothers beginning care in the first or second trimester
and from $821 to $2,166 in the same two areas for women beginning
prenatal care in the third trimester, or having no care at all.
Page last reviewed 02/28/2007
Page last modified 02/28/2007