title: Are fewer women smoking during pregnancy?
abstract: OBJECTIVE
  To determine whether pregnancy-smoking rates have changed in last decade.
  
  
  METHODS
  Retrospective cohort study of 67,395 pregnancies in Kansas City over 2 epochs, 1993-1997 and 1998-2002, using computer files of birth certificates.
  
  
  RESULTS
  Overall pregnancy-smoking rates decreased from 18.1% (95% CI=17.7-18.5%) to 14.2% (13.8-14.5%). Among smokers, there was a distribution shift toward light smoking; light [39% (38.9-40.3%) vs 49% (47.6-50.4%)], moderate [36.8% (34.8%-38.8%) vs 34.4% (32.1-36.7%)], and heavy [23.1% (21.9-26.3%) vs 16.6% (14-19.1%)].
  
  
  CONCLUSIONS
  The results suggest decreasing heavier smoking. However, the trend toward light smoking suggests decreasing self-reporting. These findings highlight the dilemma in using self-reports for public health policy and emphasize the importance of antismoking socialization for all pregnancies.
authors.affiliation: Children's Mercy Hospitals and Clinics, University of Missouri, Kansas City School of Medicine, Kansas City, MO 64108, USA. faokah@cmh.edu
authors.forename: Felix A
authors.initials: FA
authors.lastname: Okah
authors.forename: Jinwen
authors.initials: J
authors.lastname: Cai
authors.forename: Paul C
authors.initials: PC
authors.lastname: Dew
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Hoff
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008923:Missouri / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology* / Q000639:trends