Mother and daughter brushing their teeth

Maternal & Child Health Data

Tobacco Use During Pregnancy, 2021

Tobacco products that contain nicotine can harm mothers and infants when used during pregnancy. For example, tobacco use during pregnancy can increase the risk of preterm birth, low birthweight, and birth defects. Not all mothers have equal access to information about tobacco use and supports to help them stop using during pregnancy. Structural racism and disinvestment in communities of color can drive such inequities. Tobacco companies have also historically marketed their products to communities of color and under-resourced communities, contributing to differences in tobacco use across groups. The table below presents data disaggregated by race and ethnicity to help us identify inequities and work toward solutions that promote equity.

Home Visiting as Part of the Solution. Evidence suggests that prenatal home visiting helps reduce tobacco use among participating mothers. Home visiting programs offer several supports in this area, including education about the harms of smoking, motivational interviewing and other strategies to help parents stop tobacco use, and referrals to outside programs that offer tobacco use counseling.

Tobacco Use During Pregnancy by State, 2021

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State All Groups American Indian or Alaska Native Asian Black or African American Hispanic Native Hawaiian or Other Pacific Islander Multiple Races White

Notes: The original data source reports Hispanic origin separately from race variables; therefore, the population included in each race category does not exclude people of Hispanic origin. NA indicates when the data do not meet the criteria for confidentiality constraints. More information can be found at

Definition: Tobacco use during pregnancy refers to the percentage of mothers who used tobacco during pregnancy in 2021. All reporting areas, except California, routinely collect information on maternal tobacco use, but the information collected with the 2003 revision of the birth certificate is not comparable to the information collected with earlier versions of the birth certificate. Thus, maternal tobacco use data are recoded based on the birth certificate version used by the mother’s place of residence in the year of birth. These percentages exclude births where tobacco use is categorized as “not stated” or “not reported” from the total number of births (i.e. the denominator).

Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Vital Statistics. (2021). Natality records (expanded) 2016–2021 [CDC WONDER Online Database, April 2023].