Exploring transitions in prenatal maternal tobacco use: Evidence from the Pregnancy Risk Assessment Monitoring System data

Prenatal tobacco use is a critical public health issue, with substantial implications for maternal and infant health. While counseling efforts are widespread, transitions between types of tobacco use, such as from non-use to smoking, or from smoking to dual use with e-cigarettes, remain insufficiently understood. This study investigates sociodemographic predictors of changes in tobacco use patterns during pregnancy, focusing on education and marital status. Using data from the CDC's Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 (2016–2021), multivariate logistic regression models assessed associations between tobacco use transitions and key variables. Results revealed that women with higher education levels and those who were married had significantly lower odds of initiating or continuing tobacco use during pregnancy. These findings underscore the need for targeted interventions aimed at high-risk populations to promote cessation and support maternal-child health.