Abstract
ISSUE ADDRESSED: Smoking during pregnancy poses serious health risks for mother and baby. Addressing smoking among pregnant Aboriginal and Torres Strait Islander women is an Australian national priority. This study aimed to understand the geographical variation in rates of not smoking during pregnancy among Aboriginal and Torres Strait Islander women. METHODS: Data from the National Perinatal Data Collection were obtained for all births in Australia recorded between 2014 and 2017 to women aged 18 and over who were recorded as Aboriginal and/or Torres Strait Islander. Sociodemographic characteristics were obtained from national data for each of the 340 included geographic areas of residence (SA3). The characteristics associated with not smoking in the first 20 weeks of pregnancy were explored with conditional autoregressive spatial regression modelling. RESULTS: Over half (56%) of the 49 341 women included in the dataset reported they did not smoke in the first 20 weeks of pregnancy. The prevalence of not smoking ranged from 39% to 86% across geographic areas. Not smoking was highest in areas with higher median age, lower levels of socio-economic disadvantage and increased participation in employment. CONCLUSIONS: Not smoking during the first 20 weeks of pregnancy among Aboriginal and Torres Strait Islander women was strongly associated with area-level socioeconomic disadvantage driven primarily by the level of employment in the area. SO WHAT?: Targeted public health strategies that focus on areas identified as having high rates of maternal smoking and on improving employment opportunities and addressing socioeconomic disadvantage could contribute to a reduction in smoking rates.