CDC Data Show Younger Women Less Likely to Stop
Using Alcohol and Tobacco During Pregnancy
Overall, combined tobacco and alcohol use among
reproductive-aged and pregnant women decreased in late 1980s and leveled
off in the 1990s
Despite overall decreases in joint use of alcohol and tobacco among
US women of childbearing age achieved during the 1980s, the rates
remained unchanged during the 1990s. Younger women are as likely as
older women to use both substances and are less likely to stop during
pregnancy. The findings, based on 10 years of data (1987-1997) from the
Centers for Disease Control and Preventionís (CDC) Behavioral Risk
Factor Surveillance System (BRFSS), a state-based monthly telephone
survey of adults in the United States, were reported in the November
2000 issue of Obstetrics & Gynecology.
Among women 18-20 years old who were pregnant, joint use of tobacco
and alcohol remained unchanged at 4% during the 1990s, after declines in
the 1980s. For 18-20 year old women who were not pregnant, use of both
substances increased from 13.5% to 13.7%. In 1997, only 74% of pregnant
women in this age group stopped using alcohol and tobacco compared with
83% of older pregnant women.
"We cannot rest in our efforts to reduce the number of young
people who start using tobacco and alcohol," said CDC Director
Jeffrey P. Koplan. "Alcohol and tobacco use not only threaten the
health of a young woman over time, but can prevent her from becoming
pregnant, and if she is pregnant, harm her child."
Overall, although the percentage of women who reported using both
alcohol and tobacco decreased during the 1980s, the rates remained
unchanged during the 1990s both among pregnant women (3%) and
nonpregnant women (14%). From 1987 to 1997, the percentage of women who
said they stopped using tobacco and alcohol because of a pregnancy
increased slightly, but insignificantly from 70% to 82%. Pregnant women
who used both substances were much more likely to report that they
stopped using alcohol (74%) than tobacco (52%).
Other characteristics associated with joint use of both substances
were education and marital status. Joint use of alcohol and tobacco was
more common among pregnant and nonpregnant women who had less than a
high school education and who were not married. Among nonpregnant women,
nonwhite race and unemployment were risk factors for using both alcohol
"Counseling on avoiding tobacco and alcohol misuse should be an
important part of care for women of childbearing age," said the
lead author, Dr. Shahul H. Ebrahim of the CDC.
Adverse reproductive effects of alcohol and tobacco for women of
reproductive age include infertility, pre-term birth, spontaneous
abortion, and cancers. Adverse effects for children of women who use
alcohol and tobacco include fetal alcohol syndrome, birth defects,
growth deficits, developmental disabilities, and learning disorders.
Prevention of alcohol and tobacco-exposed pregnancies requires targeting
high risk women for interventions before pregnancy. One CDC study
currently underway, Project CHOICES, is testing the efficacy of this
approach by combining behavioral interventions to reduce preconceptional
alcohol use and encourage effective contraception until risk drinking is
The Centers for Disease Control and Prevention (CDC) protects
people's health and safety by preventing and controlling diseases and
injuries; enhances health decisions by providing credible information on
critical health issues; and promotes healthy living through strong
partnerships with local, national and international organizations.
The article will be available on the Obstetrics
& Gynecology website on Tuesday, October 31, 2000.
This page last reviewed November 1,
for Disease Control and Prevention