Background
Maternal smoking causes adverse health outcomes for both mothers and infants and leads
to excess healthcare costs at delivery and beyond. Even with substantial declines
over the past decade, around 23% of women enter pregnancy as a smoker and though almost
half quit during pregnancy, half or more quitters resume smoking soon after delivery.
Purpose
To examine the independent effects of higher cigarette taxes and prices, smokefree
policies, and tobacco control spending on maternal smoking prior to, during, and after
a pregnancy during a period in which states have made changes in such policies.
Methods
Data from pooled cross-sections of women with live births during 2000–2005 in 29 states
plus New York City (n=225,445) were merged with cigarette price data inclusive of federal, state, and local
excise taxes, full or partial bans on smoking in public places, and tobacco control
spending. Probit regression models using a mixed panel, state fixed effects, and time
indicators were used to assess effect of policies on smoking (during 3 months before
pregnancy); quitting by last 3 months of pregnancy; and having sustained quitting
at the time of completing the postpartum survey.
Results
Multivariate analysis indicated that a $1.00 increase in taxes and prices increases
third-trimester quits by between 4 and 5 percentage points after controlling for the
other policies and covariates. Implementing a full private worksite smoking ban increases
quits by the third trimester by an estimated 5 percentage points. Cumulative spending
on tobacco control had no effect on pregnancy smoking rates overall. Association of
tobacco control policies with maternal smoking varied by age.
Conclusions
States can use multiple tobacco control policies to reduce maternal smoking. Combining
higher taxes with smokefree policies particularly can be effective.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Healthy People 2020: improving the health of Americans.
- Trends in smoking before, during, and after pregnancy—Pregnancy Risk Assessment Monitoring System (PRAMS), U.S., 31 sites, 2000–2005.Morb Mortal Wkly Rev. 2009; 58: 1-29
- The impact of tobacco control programs on adult smoking.Am J Public Health. 2008; 98: 304-309
- State tobacco control spending and youth smoking.Am J Public Health. 2005; 95: 338-344
- Effectiveness of tax and price policies in tobacco control.Tobacco Control. 2010; 20: 235-238
- Smokefree legislation: a review of health and economic outcomes research.Am J Prev Med. 2010; 39: S66-S76
- The effect of cigarette excise taxes on smoking before, during and after pregnancy.J Health Econ. 2003; 22: 1053-1072
- The tax burden on tobacco: historical compilation, Volume 40.The Tobacco Institute, Washington DC2005
- State smoke-free laws for worksites, restaurants, and bars—U.S., 2000–2010.MMWR Morb Mortal Wkly Rep. 2011; 60: 472-475
- State Tobacco Activities Tracking and Evaluation (STATE) system.
- Best practices for comprehensive tobacco control programs—2007.
- Pregnancy Risk Assessment Monitoring System (PRAMS).
- Campaign for Tobacco Free Kids.
- Do workplace smoking bans reduce smoking.Am Econ Rev. 1999; 89: 728-747
- Public policy and smoking cessation among young adults in the U.S..Health Policy. 2004; 68: 321-332
- Cigarette taxes and youth smoking: new evidence from national, state, and local youth risk behavior surveys.J Health Econ. 2008; 27: 287-299
- Cigarette taxes and older adult smoking: evidence from recent large tax increases.J Health Econ. 2008; 27: 918-929
- Cigarette taxes and smoking during pregnancy.Am J Public Health. 2001; 91: 1851-1856
- The effect of the 1998 master settlement agreement on prenatal smoking.J Health Econ. 2006; 25: 276-294
- Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke.Am J Prev Med. 2001; 20: 16-66
- How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the Surgeon General.
- The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General—executive summary.
- Women and smoking, 2001: Surgeon General's report.
- Estimates of nondisclosure of cigarette smoking among pregnant and nonpregnant women of reproductive age in the U.S..Am J Epidemiol. 2011; 173: 355-359
- Is addiction “rational”?.Q J Econ. 2011; 116: 1261-1303
- Pregnancy and the demand for cigarettes.Am Econ Rev. 2003; 93: 1752-1763
- The effectiveness of cigarette regulations in reducing cases of sudden infant death syndrome.J Health Econ. 2008; 27: 106-133
- Low birthweight and preterm birth rates 1 year before and after the Irish workplace ban.Br J Obstet Gynecol. 2009; 116: 1782-1787
- Can public policy deter smoking escalation among young adults?.J Policy Anal Manage. 2005; 24: 771-784
- Youth smoking uptake progress: price and public policy effects.East Econ J. 2006; 32: 355-367
- State-level tobacco control policies and youth smoking cessation measures.Health Policy. 2010; 97: 136-144
- Women's labor force attachment patterns and maternity leave: a review of the literature. U.S. Bureau of the Census. Population division Working Paper No. 32.
- Treating tobacco use and dependence: clinical practice guideline.DHHS, Rockville MD2008
Article info
Identification
Copyright
© 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
