Pregnancy Study: Smoking Nearly Twice as High as Reported

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A new paper has found a large disparity between the number of pregnant women who report smoking during pregnancy and tests for nicotine exposure, a further indication of what scholars have long known: that addiction can make people deceive themselves and others about their habits, which can be difficult to beat.

Women who become pregnant often vow to live a healthier lifestyle. While some claims -- such as, it's essential to eliminate all coffee or alcohol -- lacked a real scientific basis, the weight of evidence has long been on the side of eliminating smoking. That is a gigantic risk factor for pre-term birth (up to 25 percent) and other birth defects, not to mention risking the health of the mother.

The paper in the Journal of Perinatology detected high-level nicotine exposure for 16.5 percent of 708 women who gave birth at a single maternity hospital in southwest Ohio between March 2014 and August 2015, though only 8.6 percent admitted to using cigarettes. All maternity centers now collect maternal urine samples for drug testing to address rapid increases in prenatal exposure to opioids, and due to that researchers were able to infer nicotine levels by measuring cotinine in urine because cotinine is a metabolized byproduct of nicotine exposure.

The authors try to summon popular controversy by speculating that the nicotine difference could be due to e-cigarettes, but it is the hundreds of toxic chemicals in cigarette smoke that are the real killers, not nicotine itself, which is simply addictive, like caffeine. If pregnant women are currently using any smoking-cessation or harm-reduction techniques to stop smoking, they should continue to do so.

"We have long suspected that smoking status during pregnancy is under-reported, but now we know just how many women struggle to quit smoking when they are pregnant," said Jim Greenberg, MD, director of the Perinatal Institute at Cincinnati Children's Hospital Medical Center, and senior author of the paper, in their statement.

Citation: E S Hall, S L Wexelblatt and J M Greenberg, Self-reported and laboratory evaluation of late pregnancy nicotine exposure and drugs of abuse, Journal of Perinatology 7 July 2016 doi:10.1038/jp.2016.100