Smoking and Alcohol Use During Pregnancy: Findings from the Canadian Community Health Survey

lit cigarette on black background with smoke

Overall, alcohol and tobacco are the most commonly used drugs during pregnancy in Canada. They are also the two drugs that can be the most harmful to a fetus during pregnancy and in the long-term for babies that are exposed.

New research, using data from the Canadian Community Health Survey (2003-2012), takes a closer look at this relationship. Internationally, research has shown that women who smoke are also more likely to drink and vice versa. (One study by Cannon et al showed that 74% of mothers who had a child with FASD also smoked during their pregnancy).

The researchers looked at a national sample of 22,962 women who had given birth in the previous five years. They found that the overall prevalence of smoking during pregnancy in this group of women was 14.3% (of the women who smoked, 52.5% smoked daily and 47.5% smoked occasionally). The prevalence was the lowest in British Columbia at 9.0% and the highest in the territories (Yukon, Northwest Territories, and Nunavut combined) at 39.9%.

They found that:

  • Women who smoked during pregnancy were more likely to be younger, single, white/non-immigrants, and have a lower income.
  • Women who smoked during pregnancy were more likely to drink while pregnant. Women who were daily or occasional smokers during pregnancy were 2.54 and 2.71, respectively, times more likely to have consumed alcohol during pregnancy as compared to non-smokers.
  • Women who had a lifetime history of smoking, but who did not smoke during pregnancy, were also more likely to have consumed alcohol during pregnancy.
  • Binge drinking was the only factor that had a relationship to whether women used alcohol, smoked or used both during pregnancy.

These findings suggest the importance of public health interventions that address alcohol use and smoking together both before and during pregnancy.

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Bailey, B.A., McCook, JG., Hodge, A. and McGrady, L. (2012). Infant birth outcomes among substance using women: why quitting smoking during pregnancy is just as important as quitting harder drugs. Matern Child Health J, 16:414–422.

Cannon, M.J., Dominique, Y., O’Leary, L.A., Sniezek, J.E., & Floyd, R.L. (2012). Characteristics and behaviors of mothers who have a child with fetal alcohol syndrome. Neurotoxicology and Teratology, 34: 90–95.

Janisse, J.J., Bailey, B.A., Ager, J., and Sokol, R.J. (2014). Alcohol, Tobacco, Cocaine, and Marijuana Use: Relative Contributions to Preterm Delivery and Fetal Growth Restriction. Substance Abuse, 35(1): 60-67, DOI: 10.1080/08897077.2013.804483

Lange, S., Probst, C., Quere, M., Rehm, J., Popova, S. (2015). Alcohol use, smoking and their co-occurrence during pregnancy among Canadian women, 2003 to 2011/12. Addictive Behaviors, 50: 102–109.

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