A cross-sectional study of smoking during pregnancy

Comparisons between Atlantic Canada and the rest of Canada


  • Angela Daley University of Maine
  • Shelley Phipps Dalhousie University


Prenatal smoking is harmful to fetal development, with long-term implications for health and economic well-being. The objective of this study is to compare prenatal smoking in Atlantic Canada (i.e., Newfoundland and Labrador, Prince Edward Island, Nova Scotia, New Brunswick) and the rest of Canada – to support research and policy aimed at reducing disparities. We pool three cycles of the Canadian Community Health Survey with similar design and content – Cycles 1.1 (2000-2001), 2.1 (2003), and 3.1 (2005). These are the only cycles that coincide with our objective; health regions in Atlantic Canada did not select ‘optional content’ related to prenatal smoking between 2007 and 2017, and public use microdata from 2017 (released in 2020) do not have a sufficient sample of new mothers in the region. We examine the prevalence and correlates of prenatal smoking using descriptive statistics and multivariate regressions, separately for Atlantic Canada and the rest of Canada.

We find that the proportion of women who smoked during pregnancy is higher in Atlantic Canada (30.6 percent versus 26.2 percent in the rest of Canada). However, there is no difference in the number of cigarettes per day among those who smoked. In terms of correlates, we find that the probability of prenatal smoking is higher for single women (versus married or common law) and is inversely related to household income – regardless of whether women reside in Atlantic Canada or the rest of Canada. There are, however, important differences in the effects of age, visible minority status, education, labour market status, and the provincial/territorial unemployment rate.

Based on these differences, we conclude that data from the rest of Canada should not be extrapolated to Atlantic Canada. Given the importance of prenatal smoking for subsequent health and economic well-being, we argue that health regions in Atlantic Canada should select the relevant ‘optional content’ on an ongoing basis to collect a sufficient sample of new mothers, to better understand this issue and policy options for the region.