Background: Maternal smoking during pregnancy remains a public health concern in the United States (US). We examined whether the prevalence of smoking during pregnancy decreased between 2010 and 2017 and how trends differed by demographic subgroups. Methods: We used 2010–2017 data from the National Center for Health Statistics. Rao-Scott Chi-Square tests were performed to compare characteristics between smoking and nonsmoking groups. Cochran–Armitage tests and logistic regression were used to assess overall changes in the prevalence of smoking during pregnancy over time and changes for age, race, and educational attainment subgroups. Results: The prevalence of smoking during pregnancy decreased from 9.2% in 2010 to 6.9% in 2017. In 2017, the prevalence was highest among women aged 20–24 (9.9%), American Indian/Alaskan Natives (15%), and those with a high school diploma or General Educational Development (GED) (12.2%). The prevalence was lowest among women younger than 15 (1.7%), Asian/Pacific Islanders (1%), and those who had a master’s degree and higher (0.3%). Prevalence did not decrease significantly over time in the 35–39 age group (4.5 to 4.4%; p = 0.08), and increased dramatically for women with less than a high school diploma from 10.2 to 11.8%; p < 0.0001. Conclusions: Smoking prevalence during pregnancy in the US is declining, but is highest among younger women (20–24), American Indian/Alaska Natives, and women with a high school diploma or GED. In addition, the prevalence has increased for women with the least education. Targeted research and tobacco control interventions could help address the specific needs of these high-risk subpopulations.

There is evidence that sexual minority populations have a potentially heightened risk of poor health outcomes due in part to the discrimination they may face. In the present study, we examined whether overweightness and obesity vary by sexual minority subgroup using a large, nationally representative sample. Data were drawn from 2014–2017 Behavioral Risk Factor Surveillance System (BRFSS) surveys (n = 716,609). We grouped participants according to sexual identity (straight, lesbian or gay, bisexual, and other/don’t know/not sure). The propensity score matching technique was used to address covariate imbalance among sexual identity groups. In addition, subgroup analyses were performed for both males and females. Compared to straight adults, lesbian females had significantly higher odds of being overweight (OR (odds ratio) 1.33; 95% CI (confidence interval) 1.17–1.53), whereas gay males had significantly lower odds (OR 0.66; 95% CI 0.59–0.73). Similarly, lesbians were more likely to be obese (OR 1.49; 95% CI 1.31–1.70), whereas gay men had significantly lower odds of obesity (OR 0.77; 95% CI 0.69–0.86) when compared to straight adults. Bisexual females had significantly higher odds of being overweight (OR 1.21; 95% CI 1.10–1.34) and obese (OR 1.43; 95% CI 1.29–1.59), whereas bisexual males showed no significant difference. Our results strengthen previous findings and further highlight the need for research by sexual minority subgroup.

Background: The relationship between economic conditions and substance abuse is unclear, with few studies reporting drug-specific substance abuse. The present study examined the association between economic conditions and drug-specific substance abuse admissions. Methods: State annual administrative data were drawn from the 1993–2016 Treatment Episode Data Set. The outcome variable was state-level aggregate number of treatment admissions for six categories of primary substance abuse (alcohol, marijuana/hashish, opiates, cocaine, stimulants, and other drugs). Additionally, we used a broader outcome for the number of treatment admissions, including primary, secondary, and tertiary diagnoses. We used a quasi-experimental approach -difference-in-difference model- to estimate the association between changes in economic conditions and substance abuse treatment admissions, adjusting for state characteristics. In addition, we performed two additional analyses to investigate (1) whether economic conditions have an asymmetric effect on the number of substance use admissions during economic downturns and upturns, and (2) the moderation effects of economic recessions (2001, 2008–09) on the relationship between economic conditions and substance use treatment. Results: The baseline model showed that unemployment rate was significantly associated with substance abuse treatment admissions. A unit increase in state unemployment rate was associated with a 9% increase in treatment admissions for opiates (β = 0.087, p < .001). Similar results were found for other substance abuse treatment admissions (cocaine (β = 0.081, p < .001), alcohol (β = 0.050, p < .001), marijuana (β = 0.036, p < .01), and other drugs (β = 0.095, p < .001). Unemployment rate was negatively associated with treatment admissions for stimulants (β = − 0.081, p < .001). The relationship between unemployment rate and opioids treatment admissions was not statistically significant in models that adjusted for state fixed effects and allowed for a state- unique time trend. We found that the association between state unemployment rates and annual substance abuse admissions has the same direction during economic downturns and upturns. During the economic recession, the negative association between unemployment rate and treatment admissions for stimulants was weakened. Conclusion: These findings suggest that economic hardship may have increased substance abuse. Treatment for substance use of certain drugs and alcohol should remain a priority even during economic downturns.

Background: Alcohol misuse is one of the leading causes of preventable death in the United States each year. Objectives: In the present study, we examine trends in binge and heavy drinking. We used data from the 2011–2017 Behavioral Risk Factor Surveillance System. For trend analyses, we used logistic regression for heavy drinking and binge drinking variables. Joinpoint model analysis was conducted to identify where significant changes in trend occurred. Results: The trend analysis indicated that the overall prevalence of binge drinking decreased significantly from 18.3% in 2011 to 16.0% in 2014, then increased significantly to 17.0% in 2017. This trend was also found for heavy drinking, with a significant decrease from 6.6% in 2011 to 5.8% in 2014, then increased significantly to 6.2% in 2017. This trend persisted for certain subgroups; males, females, White participants, and the 35–54 age group all had a similar decrease in prevalence followed by an increase from 2014–2017. Conclusions: Overall, our results indicate a recent significant increase in both binge and heavy drinking among the general population.