Prevalence and correlates of alcohol and tobacco use among pregnant women in the United States: Evidence from the NSDOH 2005-2014

Sehun Oh, Jennifer Reingle Gonzalez, Christopher Salas-Wright, Michael Vaughn, Diana M. DiNitto, 2017

Using the National Survey of Drug Use and Health to ascertain population-level trends, researchers compared alcohol use, tobacco use, and co-use in pregnant and non-pregnant populations of adolescents and adults. They also explored socio-behavioral correlates to substance use—namely incarceration and experiencing a major depressive episode. Their findings highlight the complex needs of adult and teen women, particularly those who use substances, have mental health concerns, and are involved in the criminal justice system.

Some of the most salient findings include that pregnant teens smoke at higher rates than their non-pregnant peers and at a higher rate than pregnant adults—23% of pregnant teens reported tobacco use, as compared to 7.5% of non-pregnant teens and around 15% of pregnant adults. However, the authors do note that prevalence of smoking decreases markedly between the first and third trimesters. The authors also observed high levels of co-use of alcohol and tobacco by both teens and adults. Pregnant teens and adults who report current alcohol use (11.5% and 8.7%, respectively) were significantly more likely to use tobacco within the past month. Experiencing a major depressive episode was another strong correlate of tobacco use (adjusted odds ratio for teens: 2.39 [95% CI: 3.32-7.39), as was being arrested or incarcerated in the past year (adjusted odds ratio for teens: 2.80 [95% CI: 1.26-6.23] and adjusted odds ratio for adults: 4.95 [95% CI: 3.32-7.39] for adults).

The high rates of tobacco use and co-use with alcohol among pregnant teens demonstrates a critical need for supportive care. Most importantly, this study demonstrates that substance use during pregnancy often occurs within a complex web of behavioral and social risk factors. Tobacco treatment for these populations is best when its holistic, patient centered, and trauma informed.

Read the full article here: Oh, Reingle Gonzalez, et al., 2017