{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:45:24Z","timestamp":1781196324111,"version":"3.54.1"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pregnancy is a critical window for tobacco cessation; socio-demographic correlates and prenatal care (PNC) utilization behaviors associated with quitting e-cigarette and dual use with conventional cigarettes remain understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the influence of socio-demographic characteristics and PNC utilization in the cessation of cigarette, e-cigarette, and dual-use during pregnancy, using Pregnancy Risk Assessment Monitoring System (2016\u20132022) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from 223,793 respondents (weighted count\u2009=\u200911,475,844) with singleton births who reported cigarette and\/or e-cigarette use during the three months before and the last three months of pregnancy. Socio-demographic and PNC cessation correlates for cigarette, e-cigarette, and dual-use were examined versus continuation using logistic regression analysis. The Adequacy of Prenatal Care Utilization (APNCU) Index assessed PNC. Associations were expressed as adjusted odds ratios with 95% confidence intervals [AOR (95%CIs)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Tobacco product use declined from 16.9% pre-pregnancy to 7.5% by late pregnancy. Pregnancy-associated cessation rates were 53.7% for cigarettes, 81.0% for e-cigarettes, and 48.1% for dual-use. Primiparity was associated with higher odds of quitting across all groups: cigarettes [1.8 (1.6\u20122.0)], e-cigarettes [1.6 (1.2\u20122.1)], and dual-use [2.3 (95% CI: 1.7\u20123.1)]. Black race and Hispanic ethnicity were positively associated with cessation of cigarettes and dual-use, while Black race was also associated with higher odds of EC cessation. A higher smoking frequency was associated with reduced cessation odds of cigarette [0.2 (0.2\u20120.3)] and dual-use [0.3 (0.2\u20120.4)], while a higher vaping frequency was associated with reduced e-cigarette cessation [0.3 (0.2\u20120.5)]. Inadequate APNCU Index was associated with lower odds of quitting cigarettes [0.6 (0.5\u20120.7)] and dual-use [0.6 (0.4\u20120.9)], but showed no significant association with e-cigarette cessation [0.9 (0.6\u20121.5)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Distinct socio-demographic and PNC factors influence cessation patterns by product type. Findings underscore potential opportunities to integrate PNC with targeted cessation support, particularly for high-risk groups amid rising e-cigarette and dual use during pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0343423","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T18:25:17Z","timestamp":1772562317000},"page":"e0343423","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tobacco product cessation and prenatal care utilization: A Pregnancy Risk Assessment Monitoring System phase 8 study of conventional cigarette, e-cigarette, and dual-use associated behaviors"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7518-3604","authenticated-orcid":true,"given":"Rathika Damodara","family":"Shenoy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3357-6351","authenticated-orcid":true,"given":"Michael","family":"Weitzman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan M.","family":"Acu\u00f1a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"pone.0343423.ref001","author":"United States Public Health Service Office of the Surgeon General, National Center for Chronic Disease Prevention and Health Promotion (US) O on S and H","year":"2020"},{"issue":"5","key":"pone.0343423.ref002","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1097\/AOG.0000000000003825","article-title":"Tobacco and nicotine cessation during pregnancy: ACOG committee opinion summary, number 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