In the most recent installment of Innovate’s series highlighting research publications from faculty members at the Boston College School of Social Work, we discuss two papers from Assistant Professor Summer Hawkins on the effects of smoking on pregnant women and their babies.
The Issue: There is a large body of research suggesting that higher cigarette taxes lead directly to decreases in adult smoking. However, to date, there have been very few studies on the effects of state tobacco control policies on pregnant women and their newborns.
The Idea: Hawkins and Christopher Baum, a professor of economics and social work at BC, set out to conduct large-scale epidemiological analyses of the habits of pregnant women and the health of their newborns. To do this, they consulted the publicly available National Vital Statistics System, which registers every birth nationwide via the birth certificate (birth certificates include all kinds of information from new mothers, including whether or not they smoked during pregnancy). They then linked the data with state tobacco control policies in order to determine whether or not certain legislation might serve to mitigate smoking in pregnant women. Of note: Hawkins and Baum paid particular attention to the effects the policies had on socioeconomic groups at highest risk of smoking.
The Findings: For both studies, Hawkins and Baum pored over a dataset comprising nearly 18 million pregnant women living in 28 states and the District of Columbia, spanning the years 2000-2010.
In the first study, which appeared in the American Journal of Public Health, they found that, while maternal smoking decreased overall during that period, the rates remained highest in white and black women without a high school degree (39.7 percent and 16.4 percent). The good news is, these same women were also the most responsive to cigarette tax increases on the whole, smoking between 14-22 fewer cigarettes per month.
In a paper following up on the initial findings, published in the Journal of American Medical Association Pediatrics, Hawkins and Baum tied smoking outcomes directly to newborns, finding lower birth weights in populations who smoked more frequently. They also found that levying cigarette taxes could have a positive impact on raising the birth weight of babies born to populations who are more likely to smoke during pregnancy.
Over the course of both studies, Hawkins and Baum also looked at other kinds of smoke-free legislation, such as banning smoking in restaurants and workplaces, to see if they had a similar impact as cigarette taxes. They learned that these types of laws did not change smoking habits.
The Next Steps: The team is currently carrying out a similar study on the impact of state tobacco control policies on smoking in adolescents. It’s another opportunity to delve deeper into the greater question as to whether policies can change behavior, and in particular, do so with regards to smoking.
The Takeaway: In short – Hawkins and Baum found that states with higher cigarette taxes experienced lower rates of maternal smoking during pregnancy and better birth outcomes, especially in white and black women with less than a high school education.
On a macro level, their studies also provided further evidence that social science research has an important role to play in the American legislative process
“When policies are developed at the state level, we don’t always think of the downstream impact they can have on various groups,” Hawkins tells BC Social Work. “In this case, as politicians were drawing up cigarette tax laws, I’m not sure that they foresaw the positive influence these taxes could have on mothers and babies.
“This is a critical lesson to learn, and I’m hopeful that our research can have a positive impact on policy moving forward, as it relates to cigarette laws and their impact on mothers and babies, but also, more broadly in how we think about the role that social science research can play in creating better directed and more socially-conscious legislation.”