title: Combined tobacco and alcohol use by pregnant and reproductive-aged women in the United States.
abstract: OBJECTIVE
  To assess trends in the concurrent use of alcohol and tobacco among pregnant women.
  
  
  METHODS
  Using behavioral risk factor surveillance system data from 1987 through 1997, we determined the prevalence of concurrent tobacco and alcohol use among women aged 18-44 years by pregnancy status and indirectly estimated pregnancy-related disuse rates.
  
  
  RESULTS
  The percentage of women who used alcohol and tobacco decreased significantly from 1987 to 1990 among pregnant (5.4% to 3.0%) and nonpregnant women (17.6% to 14.2%), but thereafter did not change significantly. The estimated pregnancy-related disuse rate of tobacco and alcohol increased insignificantly from 70% in 1987 to 82% in 1997. Among women who used both substances, pregnancy-related disuse was slightly greater for alcohol alone (74%) than for tobacco alone (52%). There was not a significant decline in concurrent use of tobacco and alcohol between 1987 and 1997 among women 18-20 years old (pregnant, 4.4% to 3.6%; nonpregnant, 13.5% to 13.7%). That age group also showed a smaller pregnancy-related disuse rate than older women (1997, 74% versus 83%).
  
  
  CONCLUSIONS
  The steady trend in concurrent use of tobacco and alcohol by young women emphasizes the need for enhanced efforts to reduce the initiation of tobacco and alcohol use by young people. Women who report abuse of tobacco or alcohol should be evaluated for abuse of both substances, and interventions should address abuse of both substances.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. sebrahim@cdc.gov
authors.forename: S H
authors.initials: SH
authors.lastname: Ebrahim
authors.forename: P
authors.initials: P
authors.lastname: Decoufle
authors.forename: A S
authors.initials: AS
authors.lastname: Palakathodi
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000639:trends; D005260:Female; D006801:Humans; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012907:Smoking / Q000453:epidemiology* / Q000639:trends; D014481:United States / Q000453:epidemiology; D016387:Women's Health