Due to changes in the collection and cleaning of birth data in early 2021, smoking during pregnancy variables prior to 2021 should not be directly compared to the same variables in and after 2021. 

The tobacco industry advertises, discounts, and displays commercial tobacco products persistently. These tailored marketing tactics often push dangerous commercial tobacco products into the communities that have the fewest resources to deal with the health problems that come with them. Use of commercial tobacco products impacts even the youngest Indiana residents, as smoking during pregnancy can harm the health of both pregnant people and their unborn children. In 2020, 10.9% of pregnant people in Indiana smoked during their pregnancy. While Indiana’s smoking during pregnancy rate has declined significantly in the past decade from 17.1% in 2010, Indiana consistently has a higher smoking during pregnancy rate compared to the U.S. median (6.0%). 

Decreasing the smoking prevalence rate among pregnant people is also an objective in the 2025 Indiana Tobacco Control Strategic Plan. (Decrease smoking prevalence rate among pregnant women from 11.8% in 2019 to 6% in 2025; Decrease smoking prevalence rate among pregnant Medicaid members from 21.1% in 2019 to 15% in 2025)
The associated strategies are listed on page 27 of the 2025 plan. The approach relies on The Clinical Practice Guidelines for Treating Tobacco Use and Dependence, The Guide to Community Preventive Services for Tobacco Control Programs, and the numerous Surgeon General's Reports on tobacco, which provide evidence on the effectiveness of community-based interventions. 

"Indiana’s HB 1133 proposed a ban on selling flavored tobacco and e-liquid such as cigarettes, e-cigarettes and smokeless tobacco that have characterizing flavors including menthol. The bill also creates penalties for any person or entity that sells a flavored tobacco product."

Source: https://www.astho.org/communications/blog/recent-federal-state-actions-limit-flavored-tobacco-products/?utm_source=informz&utm_medium=email&utm_campaign=mailer&utm_content=HPU&utm_term=FlavoredTobacco   Last accessed 3/10/2023

IDOH-TPC's Smoking and Pregnancy Fact Sheet (last updated January 2022): Pregnancy-and-Smoking.pdf
IDOH-ODA statistics explorer (natality data for 2018 and beyond): IDOH ODA Stats Explorer (in.gov)
IDOH natality reports (2017 and prior years): Health: ODA: Birth Reports (Natality) (in.gov)