Smoking prevalence among U.S. national samples of pregnant women

Several data sources exist for estimating U.S. smoking prevalence among pregnant women, yet each differs in ways that have the potential to impact the estimates. In the present study we used the Population Assessment of Tobacco and Health (PATH), the National Survey on Drug use and Health (NSDUH), and the Pregnancy Risk Assessment Monitoring System (PRAMS), three common data sources, to evaluate the following questions about estimating U.S. smoking prevalence among pregnant women: To what extent are estimates impacted by differences in whether the samples include younger (<18 years) or older (>44 years) women, represent smoking in any trimester or only the 3rd, and use data from nationally representative or more selected national samples. Among the factors examined, inclusion of younger or older women does not appear to meaningfully alter prevalence estimates. Focusing on only the third trimester likely underestimates smoking prevalence, while the influence of basing estimates on selected national subgroups of women (i.e., only women who delivered live born infants) rather than nationally representative surveys has little discernible influence. Going forward, this research area would benefit from greater consistency in explicitly discussing the sampling methods used and how these various methods may have influenced the estimates reported.