Younger Women Less Likely to Stop Using Alcohol and Tobacco During Pregnancy

      NOV 2, 2000, M2 Communications - 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 Prevention`s (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 and tobacco.

      "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 resolved.

      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.