The pregnant smoker: a preliminary investigation of the social and psychological influences.

Abstract

Smoking during pregnancy is an important challenge to public health. An understanding of the psychological and sociological bases of maternal smoking is essential to the development of effective smoking cessation interventions. The aim of this study was to explore the psychosocial factors that underpin maternal smoking. Semi-structured interviews were conducted with 200 antenatal attenders at Leicester Royal Infirmary, NHS Trust, UK. Twenty-nine per cent were smokers, 22 per cent ex-smokers and 49 per cent were never smokers. Around half of the ex-smokers (49 per cent) had reportedly given up smoking during their current pregnancy. Around a third (29.5 per cent) of the ex-smokers had experienced previous problems associated with maternal smoking, including spontaneous abortion, cot death and premature birth. Of the current smokers, 69 per cent claimed that they would like to give up smoking; indeed, 59 per cent had tried to stop smoking. Emotional factors were important in maintaining smoking for two-thirds of the smokers. Significantly more of the smokers (75 per cent) had partners who smoked compared with the never-smoking women (30 per cent; p < 0.001). There was no difference in the level of knowledge about the dangers of maternal smoking between smokers, ex-smokers and never smokers. Pregnant smokers are as aware of the health risks as non-smokers. Effective intervention strategies need to focus not only on the pregnant woman's smoking status but also offer help to partners, close family members and friends. Interventions need to address the social and psychological factors that maintain maternal smoking.