Trends in teenage smoking during pregnancy. Washington State: 1984 through 1988.

Smoking rates in the United States have decreased since 1963, but this trend is less apparent in adolescents, especially girls. Using data on birth certificates from 1984 through 1988, we analyzed smoking trends during pregnancy in teenagers in Washington State. There was a small but significant increase in the overall smoking prevalence during pregnancy between 1984 (32%) and 1988 (37%). Smoking rates varied by mother's age, race and ethnicity, marital status, and prenatal care. Whites had the highest smoking prevalence, and native Americans showed the largest increase in smoking prevalence over time. In the 5 years studied, unmarried pregnant teenagers had a smoking prevalence of 42.8%, compared with a rate of 31.7% in married teenagers. Compared with other studies of smoking rates in nonpregnant teenagers, pregnant teenagers in Washington State had a much higher smoking prevalence than their nonpregnant peers, and the differences between these two groups did not appear to diminish over time. This study suggests that there is little movement toward meeting the 1990 Health Objectives for the Nation regarding smoking in Washington State teenagers who become pregnant.