Smoking

Cigarette smoking is the leading preventable cause of death in this country, contributing substantially to deaths from cancer, lung disease, heart disease, stroke, and other causes [32]. Women's smoking rates have decreased 35 percent since their peak in 1965. Yet, 22.3 million (22.1%) of adult women were still current smokers in 1997 [33]. Unlike their adult counterparts, rates of teen girls who smoked in the past month have been increasing their smoking rates, rising from 27 percent in 1991 to 37 percent in 1997. In 1997, 70% of highschool aged girls had ever tried cigarette smoking [34].

Smoking in pregnancy substantially increases health risks to the developing fetus. It is the leading cause of premature births, and greatly increases the risks of mental retardation, miscarriage, low birth weight, and other serious health conditions in infants [35]. The 1997 National Household Survey on Drug Abuse indicated that 19.9 percent of pregnant women smoked cigarettes, with the highest rates among women in their first trimester of pregnancy and lowest among those in their third trimester28. The smoking rate among women with children under the age of 2 was 26.6 percent-indicating that some women may abstain from smoking in pregnancy, but revert back after their child is born.

Children's second-hand exposure to cigarette smoke has been shown to increase the risk of Sudden Infant Death Syndrome (SIDS), recurring ear infections, and severe respiratory illnesses such as bronchitis, pneumonia, and asthma [35].

Violence

Violence is a major public health problem for American women. More than 4.5 million women are victims of violence each year36. Of these, nearly two of every three are attacked by a relative or someone they know. Women are 6-times more likely than men to be abused by someone they know and 10-times more likely to be victims of sexual assault [36]. It is estimated that 10 to 20 percent or 1-2 out of 10 young women are the victims of sexual abuse [37]. In 1997, homicide was the second leading cause of death among women ages 15 to 24 years and the sixth leading cause of death among women ages 25 to 4438. It is the leading cause of occupational deaths in women [39], [40]. Researchers are increasingly concerned that violence may also be an important hidden cause of maternal mortality. Prevalence of violence during pregnancy appears to range from 4% to 8% [41]. Applying these percentages to the 3.9 million U.S. women who delivered live-born infants in 1995 yields the conclusion that 152,000 to 325,000 women experienced violence during their pregnancies. Thus, violence may be a more common problem for pregnant women than preeclampsia, gestational diabetes, or placenta previa41. In 1996, 16.1 percent of pregnant women reported any alcohol use; 1.3 percent reported binge drinking; and 0.5 percent reported heavy drinking (5 or more drinks per day) in the past month [28].