Abstract
Objective: Young pregnant women are more likely than other pregnant women to smoke tobacco during pregnancy and post birth. This study explored young women’s perceptions of the factors which impact their smoking cessation goals throughout pregnancy and post birth. Methods: This qualitative descriptive study was performed at two metropolitan obstetric hospitals in Western Australia. Forty three women aged 16 to 24 years old who reported smoking tobacco at their first antenatal visit were interviewed at each scheduled antenatal visit and every two weeks upto six weeks post birth. Interviews were subjected to thematic analysis. Results: A total of 244 interviews were performed; a mean of six interviews per woman (four in pregnancy and two post birth). Four overarching themes across three time periods were identified: the baby; the social bond of smoking; the chaotic nature of life; and access to social support. Pregnant women had a foetus-centric approach to cessation. Post birth those who sustained cessation held this belief for their newborn, whilst those who relapsed did not. The social bond of smoking highlighted smoking as the norm. Initially, women sought out non-smokers to support them. A partner’s smoking status post birth appeared pivotal to remaining tobacco free. The chaotic nature of life, reflected through multiple stressful, negative events, challenged women in achieving their smoking cessation goals. Women who sought social support appeared to stay smoke free post birth. Conclusion: The longitudinal nature of this study provides new insight into complex issues faced by this marginalised group of young, pregnant, tobacco smokers throughout the journey of pregnancy and post birth. Findings enhance our understanding of the complex real life issues some young pregnant Australian smokers face and may be considered when women focused smoking cessation interventions are developed.
Highlights
Tobacco smoking in pregnancy remains a preventable risk factor associated with pregnancy complications, having serious long-term health implications for both the mother and newborn infant [1]
A relationship has been found between women who smoke in pregnancy and the development of adult morbidities in their children, including coronary heart disease and type 2 diabetes [6]
As discussed in the Australian National Health and Medical Research Council (NHMRC) guidelines these participants were considered as mature young women, as they were accessing their own healthcare and caring for their own child [29]
Summary
Tobacco smoking in pregnancy remains a preventable risk factor associated with pregnancy complications, having serious long-term health implications for both the mother and newborn infant [1]. A relationship has been found between women who smoke in pregnancy and the development of adult morbidities in their children, including coronary heart disease and type 2 diabetes [6]. The children of smokers are more likely than children of non-smokers to become smokers themselves and suffer the side effects from their parents smoking such as respiratory morbidity, asthma and middle ear disease [7,8]. Smoking is a major risk factor for six of the eight leading causes of death globally [9]
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