Summer Sherburne Hawkins1, Christopher F Baum. 1. Summer Sherburne Hawkins is with the Graduate School of Social Work, Boston College, Chestnut Hill, MA. Christopher F. Baum is with the Department of Economics, Boston College, and the Deutsches Institut für Wirtschaftforschung, Berlin, Germany.
Abstract
OBJECTIVES: We evaluated the impact of state tobacco control policies on disparities in maternal smoking during pregnancy. METHODS: We analyzed 2000-2010 National Vital Statistics System natality files with 17 699 534 births from 28 states and the District of Columbia that used the 1989 revision of the birth certificate. We conducted differences-in-differences regression models to assess whether changes in cigarette taxes and smoke-free legislation were associated with changes in maternal smoking during pregnancy and number of cigarettes smoked. To evaluate disparities, we included interaction terms between maternal race/ethnicity, education, and cigarette taxes. RESULTS: Although maternal smoking decreased from 11.6% to 8.9%, White and Black women without a high school degree had some of the highest rates of smoking (39.7% and 16.4%, respectively). These same women were the most responsive to cigarette tax increases, but not to smoke-free legislation. For every $1.00 cigarette tax increase, low-educated White and Black mothers decreased smoking by nearly 2 percentage points and smoked between 14 and 22 fewer cigarettes per month. CONCLUSIONS: State cigarette taxes may be an effective population-level intervention to decrease racial/ethnic and socioeconomic disparities in maternal smoking during pregnancy.
OBJECTIVES: We evaluated the impact of state tobacco control policies on disparities in maternal smoking during pregnancy. METHODS: We analyzed 2000-2010 National Vital Statistics System natality files with 17 699 534 births from 28 states and the District of Columbia that used the 1989 revision of the birth certificate. We conducted differences-in-differences regression models to assess whether changes in cigarette taxes and smoke-free legislation were associated with changes in maternal smoking during pregnancy and number of cigarettes smoked. To evaluate disparities, we included interaction terms between maternal race/ethnicity, education, and cigarette taxes. RESULTS: Although maternal smoking decreased from 11.6% to 8.9%, White and Black women without a high school degree had some of the highest rates of smoking (39.7% and 16.4%, respectively). These same women were the most responsive to cigarette tax increases, but not to smoke-free legislation. For every $1.00 cigarette tax increase, low-educated White and Black mothers decreased smoking by nearly 2 percentage points and smoked between 14 and 22 fewer cigarettes per month. CONCLUSIONS: State cigarette taxes may be an effective population-level intervention to decrease racial/ethnic and socioeconomic disparities in maternal smoking during pregnancy.
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