Odds of alcohol use lower among insured pregnant women, tobacco still an issue, study finds
===========================================================================================

* Natalie McGill

Pregnant U.S. women with health insurance have lower odds of using alcohol but not tobacco, according to a recent study.

The research was published online July 12 in *Drug and Alcohol Dependence*.

“In thinking about the Affordable Care Act and the widespread availability of health insurance, I thought exploring the relationship between health insurance and tobacco and alcohol use in women of reproductive age would not only be important but also timely,” said lead study author Qiana Brown, PhD, MPH, LCSW, a postdoctoral research fellow at the Columbia University Mailman School of Public Health.

The study looked at alcohol and tobacco use in the past month for over 97,000 pregnant and non-pregnant girls and women between ages 12 and 44 from 2010 to 2013 in the National Survey of Drug Use and Health. Eighty-two percent of the participants were insured and 3 percent were pregnant.

Insured pregnant women had lower odds of using alcohol compared with uninsured pregnant women. Researchers said that may be linked with access to health counseling from regular prenatal care visits, as well as decades of public education campaigns, such as warning labels, about the risks of alcohol use to a developing fetus.

But past-month tobacco use was high among pregnant women regardless of insurance status, the study found. For example, in their first trimester, just over 21 percent of insured pregnant women used tobacco in the past month, compared to 23.8 percent of uninsured pregnant women.

Nearly 22 percent of all pregnant women in their first trimester used tobacco in the past month and nearly 13.5 percent in their third trimester used tobacco in the past month.

Overall, tobacco and alcohol use was at its highest in the first trimester of pregnancy when compared with the second and third. Brown said this is a missed opportunity to engage pregnant women in not only alcohol but tobacco use prevention. Just as public health education campaigns educate women about alcohol-related harms, such as fetal alcohol syndrome, there should also be campaigns informing women about the harms of prenatal tobacco use, she said. Pregnant women who smoke face a series of health risks, such as giving birth to low birthweight babies and babies that may be more likely to die from sudden infant death syndrome, according to the Centers for Disease Control and Prevention.

“Providers state that they don’t have time to engage pregnant women in tobacco use cessation efforts during prenatal visits,” Brown told *The Nation’s Health*. “We need to create systems of care that will allow providers the time they need to engage pregnant women in tobacco use prevention.”

For more information, visit [www.drugandalcoholdependence.com/article/S0376-8716(16)30197-1/abstract](http://www.drugandalcoholdependence.com/article/S0376-8716(16)30197-1/abstract).

*   Copyright The Nation’s Health, American Public Health Association