Smoking During Pregnancy

Since 1965, the prevalence of cigarette smoking among women has declined by more than half.40 In 2022, 10.0% of women were current cigarette smokers.41 Cigarette smoking during pregnancy can have adverse health outcomes for both the mother and the infant. For the mother, risks include preterm birth, stillbirth, miscarriage, and pregnancy complications, such as ectopic pregnancy.42, 43, 44, 45 For the infant, risks include birth defects, low birthweight, neurodevelopmental and behavioral problems, and sudden infant death syndrome.42, 43 Cigarette smoking during pregnancy varies by race and Hispanic origin, and metropolitan status.

Figure 23: Percentage of women who smoked during pregnancy by race and Hispanic origin, 2016–2022
Percentage of women who smoked during pregnancy by race and Hispanic origin, 2016–2022

NOTE: AIAN = American Indian or Alaska Native; NH = non-Hispanic origin; NHOPI = Native Hawaiian or Other Pacific Islander. The 1997 U.S. Office of Management and Budget standards for data on race and ethnicity were used to classify people into one of the following five racial groups: White, Black or African American, Asian, American Indian or Alaska Native, or Native Hawaiian or Other Pacific Islander. All categories are single race. Data on race and Hispanic origin are collected and reported separately. People of Hispanic origin may be of any race.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

  • The percentage of women who smoked during pregnancy decreased from 7% in 2016 to 4% in 2022.
  • For Black, non-Hispanic and White, non-Hispanic women, the percentage of women who smoked during pregnancy decreased from 2016 to 2022.
  • For American Indian or Alaska Native, non-Hispanic women, the percentage of women who smoked during pregnancy decreased from 2016 to 2020 and then did not change significantly through 2022. Throughout the period, American Indian or Alaska Native, non- Hispanic women were the most likely to smoke during pregnancy.
  • For Asian, non-Hispanic women, the percentage of women who smoked during pregnancy did not change significantly from 2016 to 2018 and then decreased through 2022.
  • For Native Hawaiian or Other Pacific Islander, non-Hispanic and Hispanic women, the percentage of women who smoked during pregnancy did not change significantly from 2016 to 2022.
  • In 2022, the percentage of women who smoked during pregnancy was highest for American Indian or Alaska Native, non-Hispanic women (11%), followed by White, non-Hispanic (5%), Black, non-Hispanic (3%), Native Hawaiian or Other Pacific Islander, non-Hispanic (2%), Hispanic (1%), and Asian, non-Hispanic (0.3%) women.

Figure 24: Percentage of women who smoked during pregnancy by metropolitan status, 2016–2022
Percentage of women who smoked during pregnancy by metropolitan status, 2016–2022

NOTE: The Office of Management and Budget classifies counties as within a metropolitan statistical areas (MSA)

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

  • From 2016 to 2022, the percentage of women who smoked during pregnancy decreased for those living in both metropolitan and nonmetropolitan counties.
  • Throughout the period, smoking during pregnancy was more common among women who lived in nonmetropolitan counties than in metropolitan counties. In 2022, the percentage of women who smoked during pregnancy was 9% for those who lived in nonmetropolitan counties, compared with 3% for those who lived in metropolitan counties.

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40 National Center for Health Statistics. (2023). Health, United States, 2020–2021: Table SmokSex. https://www.cdc.gov/nchs/data/hus/2020-2021/SmokSex.pdf

41 National Center for Health Statistics. Percentage of current cigarette smoking for adults aged 18 and over, United States, 2019–2022. National Health Interview Survey. Generated interactively: Jan 17 2024 from https://wwwn.cdc.gov/NHISDataQueryTool/SHS_adult/index.html.

42 Centers for Disease Control and Prevention. (2019, May 29). Smoking During Pregnancy. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/about/cigarettes-and-reproductive-health.html.

43 Banderali, G., Martelli, A., Landi, M., Moretti, F., Betti, F., Radaelli, G., ... & Verduci, E. (2015). Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. Journal of translational medicine, 13(1), 1–7. DOI: https://doi.org/10.1186/s12967-015-0690-y.

44 Marufu, T. C., Ahankari, A., Coleman, T., & Lewis, S. (2015). Maternal smoking and the risk of still birth: systematic review and meta-analysis. BMC public health, 15(1), 1–15. DOI: https://doi.org/10.1186/s12889-015-1552-5.

45 Avşar, T. S., McLeod, H., & Jackson, L. (2021). Health outcomes of smoking during pregnancy and the postpartum period: An umbrella review. BMC Pregnancy Childbirth, 21, Article 254. https://doi.org/10.1186/s12884-021-03729-1.

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