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% of pregnant women who abstain from smoking cigarettes


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Story Behind the Curve

Last Updated: January 2023

Author: Division of Maternal and Child Health, Vermont Department of Health

The Pregnancy Risk Assessment Monitoring System (PRAMS) is a survey of women who recently gave birth that asks about their experiences, behaviors, and healthcare utilization before, during and shortly after their pregnancy. Women receive the survey two to six months after giving birth. This report presents highlights for 2020 Vermont births.

According to the most recent PRAMS data, smoking cessation during pregnancy has been steady at 87% for 2019 and 2020, this is well below the HP 2020 goal of 98.6%.  While the trend on this curve is steadily improving, the rate of improvement is slow.

The most recent available data is represented below:

  • Two in ten (19%) women smoked cigarettes in the three months prior to pregnancy.
  • One in ten (11%) smoked cigarettes during their last trimester, meaning that 40% of those smoking before pregnancy quit before the last three months.
  • More than three-quarters (78%) of smokers used at least one strategy to quit smoking during pregnancy.
  • 71% of smokers said a doctor, nurse, or other health care worker advised them to quit smoking during a prenatal visit

Continued post partum supports for sustaining smoking cessation are also important, about one third (35%) of women who quit smoking during pregnancy resume smoking by the end of the first year after birth.

Policy factors influencing the curve include policies that have an impact on smoking rates in the general population, especially those that decrease smoking initiation among young women. Visit our  tobacco surveillance page for more information on the work being across Vermont.

Efforts undertaken to address smoking cessation in pregnancy include:

  • The One More Question campaign to provide resources and education for perinatal people and providers
  • Additional Resources through 802Quits for pregnant people
  • Expansion of evidence-based home visiting programs to screen and educate pregnant and parenting people
Why Is This Important?

According to the CDC:

  • Mothers who smoke are more likely to deliver preterm, a leading cause of death, disability, and disease among newborns.
  • One in every five babies born to mothers who smoke during pregnancy has low birth weight.
  • Babies whose mothers smoke while pregnant or who are exposed to secondhand smoke after birth have weaker lungs than other babies, which increases the risk for many health problems.

This indicator is part of Healthy Vermonters 2020 (the State Health Assessment).  This assessment documents the health status of Vermonters at the start of the decade and the population health indicators and goals that guided the work of public health through 2020.  The Health department is excited to showcase the new set of Healthy Vermonters 2030 objectives coming soon.   Click here for more information.

  • Department of Vermont Health Access
  • Quit Partners – collaboration between Blueprint and VDH and the tobacco cessation specialists serving communities across the state,
What Works

The CDC recommends the following individual strategies to address smoking in pregnancy:

  • Pregnancy-specific counseling by health care providers
  • Nicotine replacement therapies, under close supervision by a health care provider
  • Quitline counseling
  • Provider reminders, documentation of smoking status and cessation interventions

MCH programs and partners continue to implement and support CDC recommended strategies.

  • Home visitors and Health Department staff who work with pregnant women screen women and refer to appropriate cessation resources at each contact

Similar to statewide efforts, local partners are using data to drive local strategy. For regional data on Maternal and Infant Health indicators, check out our Public Health Data Explorer.

Notes on Methodology

Data is updated as it becomes available and timing may vary by data source.

The PRAMS sample of women who have had a recent live birth is drawn from the state's birth certificate file. Each participating state samples between 1,300 and 3,400 women per year. Women from some groups are sampled at a higher rate to ensure adequate data are available in smaller but higher risk populations. Selected women are first contacted by mail. If there is no response to repeated mailings, women are contacted and interviewed by telephone. Data collection procedures and instruments are standardized to allow comparisons between states.

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