title: Age and racial/ethnic disparities in prepregnancy smoking among women who delivered live births.
abstract: BACKGROUND
  Prenatal smoking prevalence remains high in the United States. To reduce prenatal smoking prevalence, efforts should focus on delivering evidence-based cessation interventions to women who are most likely to smoke before pregnancy. Our objective was to identify groups with the highest prepregnancy smoking prevalence by age within 6 racial/ethnic groups.
  
  
  METHODS
  We analyzed data from 186,064 women with a recent live birth from 32 states and New York City from the 2004-2008 Pregnancy Risk Assessment Monitoring System (PRAMS), a population-based survey of postpartum women. We calculated self-reported smoking prevalence during the 3 months before pregnancy for 6 maternal racial/ethnic groups by maternal age (18-24 y or ≥25 y). For each racial/ethnic group, we modeled the probability of smoking by age, adjusting for education, Medicaid enrollment, parity, pregnancy intention, state of residence, and year of birth.
  
  
  RESULTS
  Younger women had higher prepregnancy smoking prevalence (33.2%) than older women (17.6%), overall and in all racial/ethnic groups. Smoking prevalences were higher among younger non-Hispanic whites (46.4%), younger Alaska Natives (55.6%), and younger American Indians (46.9%). After adjusting for confounders, younger non-Hispanic whites, Hispanics, Alaska Natives, and Asian/Pacific Islanders were 1.12 to 1.50 times as likely to smoke as their older counterparts.
  
  
  CONCLUSIONS
  Age-appropriate and culturally specific tobacco control interventions should be integrated into reproductive health settings to reach younger non-Hispanic white, Alaska Native, and American Indian women before they become pregnant.
authors: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS-K22, Atlanta, GA 30341, USA. vtong@cdc.gov
authors: Van T
authors: VT
authors: Tong
authors: Patricia M
authors: PM
authors: Dietz
authors: Lucinda J
authors: LJ
authors: England
authors: Sherry L
authors: SL
authors: Farr
authors: Shin Y
authors: SY
authors: Kim
authors: Denise
authors: D
authors: D'Angelo
authors: Jennifer M
authors: JM
authors: Bombard
mesh_terms: D000293:Adolescent; D000328:Adult; D005006:Ethnicity; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D054624:Health Status Disparities; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth; D008425:Maternal Behavior / Q000208:ethnology*; D009519:New York City / Q000453:epidemiology; D011159:Population Surveillance; D011247:Pregnancy; D015995:Prevalence; D060728:Reproductive Health; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D016387:Women's Health; D055815:Young Adult