1 Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
2 Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
Public Health Rep. 2018 Nov;133(6):644-649. doi: 10.1177/0033354918793120. Epub 2018 Oct 2.
We examined trends in prevalence rates of smoking and smoking cessation during pregnancy among women in the United States to assess achievement of Healthy People 2020 prevention targets.
We assessed the smoking habits of 30 667 mothers whose children were born between 1985 and 2014 and who were sampled by the National Health and Nutrition Examination Survey, 1999-2014. Sampled participants were children aged 0-15 at the time of interview; however, an adult proxy-usually the biological mother-responded on the child's behalf and reported information about maternal tobacco use during pregnancy. We calculated prevalence rates, adjusted odds ratios (aORs), and predicted annual increase or decrease of smoking and quitting smoking during pregnancy, adjusting for mother's age at delivery and income level and child's race/ethnicity and sex.
The average annual prevalence of smoking at any time during pregnancy decreased from 25.7% (95% confidence interval [CI], 15.3%-36.0%) in 1985 to 10.1% (95% CI, 7.1%-13.0%) in 2014 ( P < .001), and quitting smoking at any time during the index pregnancy increased from 36.6% (95% CI, 20.3%-52.9%) in 1985 to 54.9% (95% CI, 44.4%-65.4%) in 2008 ( P = .002). The adjusted annual risk of smoking during pregnancy decreased significantly by 3% (aOR = 0.97; 95% CI, 0.95-0.98; P < .001). The prevalence rate of smoking in the year 2020 extrapolated from the current trend would be 6.1%.
Smoking during pregnancy in the United States is declining. However, renewed public health measures are needed to achieve the Healthy People 2020 objectives of preventing smoking among pregnant women in the United States.
本研究旨在分析美国孕妇吸烟率及戒烟率的变化趋势，以评估《2020 年健康人群》预防目标的实现情况。
本研究纳入了 1999 年至 2014 年期间参加国家健康和营养调查（NHANES）的 30667 名产妇，分析了这些产妇的吸烟习惯。调查时，其子女的年龄为 0-15 岁，通常由产妇的成年亲属（通常为母亲）代表儿童接受访谈，并报告产妇孕期的吸烟情况。本研究计算了孕期吸烟和戒烟的流行率、调整后的比值比（aOR），并预测了吸烟率和戒烟率的年度变化，同时还调整了产妇的分娩年龄、收入水平、儿童的种族/民族和性别等因素。
在整个孕期任何时候吸烟的平均年流行率从 1985 年的 25.7%（95%可信区间[CI]，15.3%-36.0%）下降至 2014 年的 10.1%（95% CI，7.1%-13.0%）（ P <.001），孕期任何时候戒烟的比例从 1985 年的 36.6%（95% CI，20.3%-52.9%）增加至 2008 年的 54.9%（95% CI，44.4%-65.4%）（ P =.002）。调整后的孕期吸烟风险每年显著下降 3%（aOR = 0.97；95% CI，0.95-0.98； P <.001）。从当前趋势外推，2020 年美国孕妇吸烟率预计为 6.1%。
美国孕妇吸烟率呈下降趋势。然而，为实现《2020 年健康人群》目标，需要采取新的公共卫生措施来预防美国孕妇吸烟。
