PURPOSE: The purpose of this study was to examine the prevalence of smoking before, during, and after pregnancy among a representative sample of Massachusetts women with and without disabilities.

METHODS: Data from the 2007 to 2009 Massachusetts Pregnancy Risk Assessment Monitoring System survey were used to estimate the prevalence of smoking by disability status.

MAIN FINDINGS: Disability prevalence was 4.8% (n = 204) among Massachusetts women giving birth during 2007 through 2009. The prevalence of smoking during the 3 months before pregnancy among women with disabilities was 37.3% (95% CI, 28.3-47.2%) compared with 18.3% (95% CI, 16.6-20.1%) among women without disabilities. Similarly, 25.2% (95% CI, 17.3-35.2%) of women with disabilities, compared with 9.4% of women without disabilities (95% CI, 8.1-10.8%), smoked during the last trimester of their pregnancy, and 32.1% of women with disabilities (95% CI, 23.5-42.1%) compared with 12.5% of women without disabilities (95% CI, 11.1-14.1%), smoked after pregnancy. In the multivariate logistic regression models, women with disabilities had significantly higher risks of smoking before, during and after pregnancy than women without disabilities (adjusted relative risk [aRR], 1.7 [95% CI, 1.2-2.2]; aRR, 1.9 [95% CI, 1.3-2.8]; aRR, 1.8 [95% CI, 1.3-2.5], respectively) while adjusting for race/Hispanic ethnicity, marital status, education, age, household poverty status, and infant's birth year.

IMPLICATIONS: Women with disabilities are more likely to smoke before, during, and after their pregnancy and less likely to quit smoking during pregnancy. Efforts to integrate and target pregnant women with disabilities in smoking-cessation programs are vital.