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Cross sectional study
Reliance on self-reporting underestimates pregnancy smoking rates in Scotland, with more than 2400 pregnant smokers estimated to be missed each year
  1. Van T Tong,
  2. Patricia M Dietz,
  3. Lucinda J England
  1. Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, Georgia, USA
  1. Correspondence to Van T Tong
    Centers for Disease Control and Prevention, Division of Reproductive Health, 4770 Buford Highway NE, MS K-22, Atlanta, GA 30341, USA; vtong{at}cdc.gov

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Smoking during pregnancy is a preventable cause of infant morbidity and mortality, yet prenatal smoking is a persistent problem, with an estimated 6–22% of women in high-income countries reporting smoking cigarettes during pregnancy.1 Clinic-based interventions are effective in increasing cessation and improving pregnancy outcomes2; however, delivery of these interventions depends on the ability of providers to assess a woman's smoking status and readiness to quit accurately.

Shipton and colleagues sought to estimate the biochemically validated prevalence of women in need of smoking cessation services. Using a random sample of all 2004 births from the West of Scotland, they compared routinely collected self-reported smoking status of pregnant women at maternity booking (8–12 weeks of gestation) and serum cotinine levels from prenatal screening (15–16 weeks of gestation). They found that maternal self-reported smoking status underestimated smoking prevalence by 25%. The authors' findings are consistent with previously published clinical and observational studies in which maternal …

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