National Survey on Drug Use and Health Pregnancy and Substance Use
January 2, 2004

Pregnancy and Substance Use

In Brief

  • In 2002, 3 percent of pregnant women aged 15 to 44 used illicit drugs in the past month, 3 percent reported binge alcohol use, and 17 percent reported smoking cigarettes in the past month

  • Pregnant women aged 15 to 25 were more likely to use illicit drugs, binge drink, and smoke cigarettes in the past month than pregnant women aged 26 to 44

  • Among pregnant women aged 15 to 44, whites were more likely to have smoked cigarettes in the past month than blacks or Hispanics
    •

Substance use during pregnancy has garnered substantial medical, governmental, and media attention because of the risks that illicit drug, alcohol, and tobacco use pose to unborn children.1,2,3,4 The 2002 National Survey on Drug Use and Health (NSDUH) asks female respondents aged 15 to 44 whether they are currently pregnant and how far along in the pregnancy they are.5 The 2002 NSDUH also asks respondents about their past month use of illicit drugs, alcohol, and tobacco. Any illicit drug includes marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or any prescription-type drugs used nonmedically. Binge alcohol use is defined as drinking five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. Heavy alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days; all heavy alcohol users are also binge alcohol users. This report examines illicit drug, alcohol, and tobacco use among pregnant and nonpregnant women aged 15 to 44.6

Prevalence of Illicit Drug Use
In 2002, approximately 3 percent of pregnant women aged 15 to 44 years had used an illicit drug in the past month compared with 9 percent of nonpregnant women in this age group. Marijuana was the most widely used illicit drug among pregnant and nonpregnant women.

The rate of illicit drug use was higher among nonpregnant women than among pregnant women, regardless of age, and pregnant women aged 15 to 25 were more likely to use illicit drugs in the past month than pregnant women aged 26 to 44 (Figure 1). Among pregnant women aged 15 to 44, approximately 6 percent of blacks, 4 percent of whites, and 2 percent of Hispanics used illicit drugs in the past month (Figure 1). White and Hispanic women who were pregnant had lower rates of illicit drug use than nonpregnant women of the same age. However, among black women, the rate of past month illicit drug use was not statistically different between those who were pregnant and those who were not pregnant.

Figure 1. Percentages of Past Month Any Illicit Drug Use among Women Aged 15 to 44, by Pregnancy Status, Age, and Race/Ethnicity*: 2002

Figure 2. Percentages of Past Month Binge Drinking among Women Aged 15 to 44, by Pregnancy Status, Age, and Race/Ethnicity*: 2002
Figure 1. Percentages of Past Month Any Illicit Drug Use among Women Aged 15 to 44, by Pregnancy Status, Age, and Race/Ethnicity*: 2002 Figure 2. Percentages of Past Month Binge Drinking among Women Aged 15 to 44, by Pregnancy Status, Age, and Race/Ethnicity*: 2002

Prevalence of Alcohol Use
Among pregnant women, 9 percent reported drinking any alcohol in the past month, 3 percent reported binge alcohol use, and less than 1 percent reported heavy alcohol use in the month prior to the survey. Pregnant women were less likely to binge drink and drink alcohol heavily than nonpregnant women.

The rate of past month binge alcohol use among pregnant women aged 15 to 25 (5 percent) was more than twice the rate reported by pregnant women aged 26 to 44 (2 percent) (Figure 2). White, black, and Hispanic women who were pregnant had lower rates of past month binge drinking than nonpregnant women of the same age.

Prevalence of Cigarette Use
The rate of past month cigarette smoking among nonpregnant women (31 percent) was about twice the rate among pregnant women (17 percent). Pregnant women aged 15 to 25 were more than twice as likely to have smoked cigarettes in the past month as pregnant women aged 26 to 44 (Figure 3). In addition, nonpregnant women were more likely to have smoked cigarettes in the past month than pregnant women, regardless of age. White, black, and Hispanic women who were pregnant had lower rates of past month cigarette use than nonpregnant women of the same age. However, 24 percent of pregnant white women smoked cigarettes in the past month, as did 7 percent of pregnant black women and 6 percent of pregnant Hispanic women.

Figure 3. Percentages of Past Month Cigarette Use among Women Aged 15 to 44, by Pregnancy Status, Age, and Race/Ethnicity*: 2002

Figure 4. Percentages of Women Aged 15 to 44 Reporting Past Month Substance Use, by Pregnancy and Recent Motherhood Status**: 2002
Figure 3. Percentages of Past Month Cigarette Use among Women Aged 15 to 44, by Pregnancy Status, Age, and Race/Ethnicity*: 2002 Figure 4. Percentages of Women Aged 15 to 44 Reporting Past Month Substance Use, by Pregnancy and Recent Motherhood Status**: 2002

Prevalence of Use in the Year After Giving Birth
The rates of past month illicit drug, alcohol, and tobacco use among recent mothers were higher than the rates for pregnant women and similar to the rates for nonpregnant women (Figure 4).7 For example, among women aged 15 to 44, the rate of past month illicit drug use for recent mothers (9 percent) was similar to the rate among nonpregnant women (10 percent), with both groups reporting a higher rate of past month illicit drug use than pregnant women (3 percent). The data presented in Figure 4 suggest that women aged 15 to 44 use alcohol, tobacco, and illicit drugs less during pregnancy, but increase their substance use after giving birth.

End Notes
  1. Huestis, M. A., & Choo, R. E. (2002). Drug abuse's smallest victims: In utero drug exposure. Forensic Science International, 128 (1–2), 20–30.


  2. Centers for Disease Control and Prevention. (2001, April). Women and smoking: A report of the Surgeon General – 2001. Retrieved September 16, 2003, from http://www.cdc.gov/tobacco/sgr/sgr_forwomen/index.htm


  3. National Institute on Alcohol Abuse and Alcoholism (2000, December). Fetal alcohol exposure and the brain (Alcohol Alert No. 50). Retrieved September 16, 2003, from http://www.niaaa.nih.gov/publications/aa50.htm


  4. Cornelius, M. D., Day, N. L., Richardson, G. A., & Taylor, P. M. (1999). Epidemiology of substance abuse during pregnancy. In P. J. Ott & R. E. Tarter (Eds.), Sourcebook on substance abuse: Etiology, epidemiology, assessment, and treatment (pp. 1–13). Needham Heights, MA: Allyn & Bacon, Inc.


  5. Because of improvements and modifications to the 2002 NSDUH, 2002 estimates should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time.


  6. Except for women who had been pregnant for less than one month, the information on past month illicit drug, alcohol, and tobacco use indicates past month use during pregnancy. However, these estimates are conservative because they only reflect past month use during pregnancy, not substance use at any point during the pregnancy. The estimates of past month substance use reflect those women who were pregnant at the time of the survey, not among all women who were pregnant in 2002.


  7. For this section of the report, nonpregnant, recent mothers were defined as women aged 15 to 44 who were not currently pregnant and who gave birth during the prior year. Nonpregnant, not recent mothers were defined as women aged 15 to 44 who were not currently pregnant and who did not have a biological child under 1 year old in the household. This definition of nonpregnant women is different than in the previous sections of this report.
Figure Notes
* Estimates for American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, and Asian respondents are not shown due to small sample sizes.

** Pregnant women were those women aged 15 to 44 who were currently pregnant at the time of the survey. Nonpregnant, recent mothers were defined as women aged 15 to 44 who were not currently pregnant and who gave birth during the prior year. Nonpregnant, not recent mothers were defined as women aged 15 to 44 who were not currently pregnant and who did not have a biological child under 1 year old in the household. This definition of nonpregnant women is different than in the previous sections of this report.

Source: SAMHSA 2002 NSDUH.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). Prior to 2002, this survey was called the National Household Survey on Drug Abuse (NHSDA). The 2002 data are based on information obtained from 68,126 persons aged 12 or older, including 1,104 pregnant women aged 15 to 44. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI in Research Triangle Park, North Carolina.

Information and data for this issue are based on the following publication and statistics:

Office of Applied Studies. (2003). Results from the 2002 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 03–3836, NHSDA Series H–22). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Also available on-line: http://www.oas.samhsa.gov.

Additional tables available upon request.

Because of improvements and modifications to the 2002 NSDUH, estimates from the 2002 survey should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time.
The NSDUH Report (formerly The NHSDA Report) is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this fact sheet may be downloaded from Other reports from the Office of Applied Studies are also available on-line on the OAS home page: http://www.oas.samhsa.gov

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