Resource Center

Go back to Resource Center

Prenatal Polysubstance Use among Women who Report Smoking Cigarettes in the Month Prior to Pregnancy



Coleman-Cowger, V.H.; Oga, E.A.; Mark, K.

Society for Research on Nicotine and Tobacco Annual Conference

San Francisco, CA


Significance Cigarette smoking prior to pregnancy is often a predictor for continued smoking during pregnancy. The negative maternal and neonatal health implications of smoking during pregnancy have been well-established; however, recent studies suggest that women who stop smoking during pregnancy may continue use of other substances that are perceived as less risky or may continue smoking while using multiple other substances that may have additive or multiplicative negative health effects. It is important to understand how cigarette smoking is associated with use of other substances during pregnancy, including alcohol, cannabis, and prescription pain medications. Methods A convenience sample of 500 pregnant women was recruited from two urban prenatal clinical settings between January 2017 and January 2018. Participants completed the 4P’s Plus screener, which inquired about substance use in the month prior to pregnancy and in the past month. Participants who self-reported smoking any cigarettes in the month prior to pregnancy were further assessed to determine past-month use of other substances. Descriptive analyses were conducted to examine prenatal polysubstance use and frequency of prenatal use in the past month. Results A total of 140 pregnant women reported smoking cigarettes in the month prior to pregnancy, with 84 continuing to smoke during pregnancy and 56 recently quit. Average age was 27.5 (SD: 4.7) years; 29%, 40% and 31% were 1st, 2nd and 3rd trimesters respectively. Past month alcohol use [21.4% v 14.3%, p=0.44] and prescription drug use [7.1% v 1.8%, p=0.48] were not significantly different between recent quitters and continued smokers. Prenatal cannabis use was significantly less common among recent quitters than continued smokers [53.6% v 14.3%, p <0.0001]. Conclusion Pregnant women who continue to smoke tobacco cigarettes during pregnancy are significantly more likely to also use cannabis during pregnancy. This indicates that it is important to screen all women, particularly those who smoke tobacco, for cannabis use in pregnancy and to counsel about the potential negative, additive effects on neonatal outcomes.

Go back to Resource Center