Cited by 276Smoking Behavior and CessationPrenatal Substance Exposure EffectsSurvey Methodology and Nonresponse

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Estimates of Nondisclosure of Cigarette Smoking Among Pregnant and Nonpregnant Women of Reproductive Age in the United States

Dietz, P. M., Homa, D., England, L. J., Burley, K., Tong, V. T., Dube, S. R., Bernert, J. T.·2011·American Journal of Epidemiology

DOI 10.1093/aje/kwq381

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Abstract

Although clinic-based studies have used biochemical validation to estimate the percentage of pregnant women who deny smoking but are actually smokers, a population-based estimate of nondisclosure of smoking status in US pregnant women has not been calculated. The authors analyzed data from the 1999-2006 National Health and Nutrition Examination Survey and estimated the percentage of 994 pregnant and 3,203 nonpregnant women 20-44 years of age who did not report smoking but had serum cotinine levels that exceeded the defined cut point for active smoking (nondisclosure). Active smoking was defined as self-reporting smoking or having a serum cotinine concentration that exceeded the cut point for active smoking. Overall, 13.0% (95% confidence interval (CI): 8.8, 17.1) of pregnant women and 29.7% (95% CI: 27.3, 32.1) of nonpregnant women were active smokers. Nondisclosure was higher among pregnant active smokers (22.9%, 95% CI: 11.8, 34.6) than among nonpregnant smokers (9.2%, 95% CI: 7.1, 11.2). Among pregnant active smokers, nondisclosure was associated with younger age (20-24 years). Among nonpregnant active smokers, nondisclosure was associated with Mexican-American and non-Hispanic black race/ethnicity. Studies and surveillance systems that rely on self-reported smoking status are subject to underestimation of smoking prevalence, especially among pregnant women, and underreporting may vary by demographic characteristics.

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Grøtvedt, L., Egeland, G. M., Kvalvik, L. G., & Madsen, C. (2020) · Figshare · doi:10.6084/m9.figshare.13279874
Additional file 4 of Evaluation of incomplete maternal smoking data using machine learning algorithms: a study from the Medical Birth Registry of Norway
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Maternal smoking and risk of childhood cancer: a report from the Childhood Cancer and Leukemia International Consortium
Domingues, A. M., Spector, L. G., Tettamanti, G., Feychting, M., Nikkilä, A., Auvinen, A. P., Alimam, W., Abuhamed, J., Scheuer, M. E., Lupo, P. J., et al. (2026) · International Journal of Epidemiology · doi:10.1093/ije/dyag225

Authors: Dietz, P. M., Homa, D., England, L. J., Burley, K., Tong, V. T., Dube, S. R., & Bernert, J. T.
Affiliations: Centers for Disease Control and Prevention (US)
Corresponding author: Dietz, P. M.
ORCID: Dietz, P. M.
Homa, D.
England, L. J.
Tong, V. T.
Dube, S. R.
Venue: American Journal of Epidemiology
Publisher: Oxford University Press (OUP)
Published: 2010-12-22
Volume: 173
Issue: 3
Pages: 355-359
ISSN: 0002-9262 (ISSN-L)
1476-6256
DOI: 10.1093/aje/kwq381
OpenAlex: W2139614200
Cited by: 276
References: 15
Citations by year: 2026: 8 · 2025: 9 · 2024: 14 · 2023: 13 · 2022: 9 · 2021: 15 · 2020: 22 · 2019: 26 · 2018: 21 · 2017: 16 · 2016: 21 · 2015: 21 · 2014: 30 · 2013: 23 · 2012: 20
FWCI: 10.82
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Epidemiology (publishedVersion)
PubMed (publishedVersion)
Funders: Centers for Disease Control and Prevention
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
Keywords: cigarette smoking, non-disclosure, pregnant women, self-reported smoking status, serum cotinine, women of reproductive age, Mexican American women, non-Hispanic Black women, age differences, NHANES
MeSH terms: Adult, Black or African American, Cotinine, Female, Humans, Nutrition Surveys, Pregnancy, Smoking, Truth Disclosure, United States, Bias, Logistic Models, Mexican Americans, Age Distribution, Pregnant People, Young Adult

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Estimates of Nondisclosure of Cigarette Smoking Among Pregnant and Nonpregnant Women of Reproductive Age in the United States

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