Getting focused: Missed opportunities for smoking interventions for pregnant women receiving Medicaid

Ruth Petersen, Kathryn A. Clark, Katherine E. Hartmann, Cathy L. Melvin

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background. The prevalence of smoking, and cessation and relapse rates for pregnant women have health and financial implications. Our objectives were to describe smoking among pregnant smokers receiving Medicaid including characteristics associated with reporting discussion of smoking with providers and the association between those discussions with quitting and maintenance. Methods. Analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) data from 15 states for 20,287 women with Medicaid for prenatal care during 1998-2000. Results. Thirty-four percent of women smoked before pregnancy (N = 7,686). Most smokers (93%) and nonsmokers (88%) reported discussions about smoking during prenatal care. Women were less likely to have discussed smoking if they were lighter smokers (OR = 1.47; CI = 1.03, 2.12), or reported a previous low-birthweight infant (OR = 1.72; CI = 1.03-2.86). Women reporting discussions (compared to those not) were less likely to quit (ARR = 0.70: CI = 0.59-0.91). Quitters reporting discussions (compared to those not) were no more likely to maintain cessation (ARR = 0.89; CI = 0.7, 1.21). Conclusions. Smoking cessation interventions can be improved for pregnant women receiving Medicaid, especially if focused to address individual needs of light smokers, those with previous low-birthweight infants, or those who find it most difficult to quit.

Original languageEnglish
Pages (from-to)209-215
Number of pages7
JournalPreventive Medicine
Issue number2
StatePublished - Feb 2005


  • Pregnancy
  • Pregnant women
  • Prenatal care
  • Smoking
  • Smoking cessation

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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