Abstract
Smoke-free pregnancies have long-term health benefits for mothers and babies. This paper quantitatively examines factors associated with smoke-free pregnancies among Aboriginal and Torres Strait Islander women (hereafter Aboriginal women) and qualitatively explores their smoking cessation (SC) experiences during pregnancy. An Aboriginal-led online cross-sectional study on SC was conducted with Aboriginal women and in partnership with Aboriginal communities, between July and October 2020. The present analysis includes participants who made a pregnancy-related quit attempt (N = 103). Chi-squared tests, logistic regression models, and thematic analysis of free-form text responses were performed. The adjusted odds of having smoke-free pregnancies were 4.54 times higher among participants who used Aboriginal Health Services (AHS) (AOR = 4.54, p-value 0.018). Participants living in urban settings had 67% lower odds of having smoke-free pregnancies compared to their regional/remote counterparts (AOR = 0.33, p-value 0.020). Qualitative data revealed strong motivations to reduce tobacco-related harms to the fetus and variability in quitting experiences at different stages of and across pregnancies. Smoking cessation care (SCC) can support Aboriginal women meaningfully if their quitting experiences are considered in SCC development and implementation. Consistent funding for AHS-led SCC is needed to garner health benefits for Aboriginal peoples. More research into urban versus regional/remote differences in maternal SC is recommended.
Highlights
Smoking in pregnancy remains a major public health concern
The evidence presented in this paper may be relevant in addressing smoking during pregnancy among First Nation women in other high-income countries. To address this gap in the evidence, this paper aims to (a) quantitatively examine the factors associated with smoke-free pregnancies among Aboriginal women in Australia and (b) qualitatively describe women’s self-reported experiences of quitting during pregnancy
The present paper reports data from 24 of the survey items pertaining to demographic characteristics, smoking-related variables, use of Aboriginal Health Services (AHS), and remoteness of location
Summary
Smoking in pregnancy remains a major public health concern. First Nation peoples in high-income countries, namely, the United States of America (USA), Canada, New. Zealand, and Australia, are disproportionally affected by tobacco smoking [1], with current health inequity being related to colonisation. Smoking during pregnancy is more common among First Nation women compared to women in the general population in high-income countries [1]. Stressful life events, lack of access to culturally appropriate smoking cessation support, and a high prevalence of smoking in First Nation communities, owing to the legacy of colonisation instilled into public policies, are some of the major contributing factors to persistent smoking during pregnancy [1,2,3].
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