Why do women continue to smoke in pregnancy?

School of Nursing & Midwifery, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia.
Women and Birth (Impact Factor: 1.57). 01/2008; 20(4):161-8. DOI: 10.1016/j.wombi.2007.08.002
Source: PubMed


Smoking during pregnancy not only impacts on the woman's health but that of her unborn child. Women most likely to continue smoking throughout pregnancy are generally of lower age, socio-economic status, level of education and occupational status. Women who continue to smoke during pregnancy often feel criticized by society. They feel guilt and personal conflict at not quitting. Lack of long-term positive outcomes from anti-smoking campaigns may result form ignorance surrounding socio-economically disadvantaged women's life circumstances. Current interventions often ignore the emotional and psychological stressors associated with pregnancy; they do not address the altered physiological processes that occur during pregnancy. A review of the literature pertaining to women who smoke throughout pregnancy is presented. Women want an individualised approach to smoking cessation advice, with health care workers having knowledge of the woman's social situation and viewpoints. This paper reveals that the woman's perspective has largely been ignored. Indeed health care professionals have attempted to manipulate women to stop smoking rather than engage in mutually respectful dialogue.

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    • "It is unclear whether this association is due to socioeconomic factors or is specifically health-related. Women who continue smoking throughout pregnancy are generally of lower age, socio-economic status, level of education and occupational status than non-smokers [49], and offspring are exposed to higher levels of social disadvantage and family dysfunction throughout childhood [50]. "
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    ABSTRACT: Background Though migraine and tension type headache are both commonly diagnosed in childhood, little is known about their determinants when diagnosed prior to puberty onset. Our aim was to determine psychosocial- and health-related risk factors of migraine and tension-type headache in 11 year old children. Methods 871 New Zealand European children were enrolled in a longitudinal study at birth and data were collected at birth, 1, 3.5, 7, and 11 years of age. Primary headache was determined at age 11 years based on the International Headache Society. Perinatal factors assessed were small for gestational age status, sex, maternal smoking during pregnancy, maternal perceived stress, and maternal school leaving age. Childhood factors assessed were sleep duration, percent body fat, television watching, parent and self-reported total problem behaviour, being bullied, and depression. Results Prevalence of migraine and tension-type headache was 10.5% and 18.6%, respectively. Both migraine and TTH were significantly associated with self-reported problem behaviour in univariable logistic regression analyses. Additionally, migraine was associated with reduced sleep duration, and both sleep and behaviour problems remained significant after multivariable analyses. TTH was also significantly associated with antenatal maternal smoking, higher body fat, and being bullied. For TTH, problem behaviour measured at ages 3.5 and 11 years both remained significant after multivariable analysis. Being born small for gestational age was not associated with either headache group. Conclusions Although they share some commonality, migraine and tension-type headache are separate entities in childhood with different developmental characteristics. The association between primary headache and problem behaviour requires further investigation.
    Full-text · Article · Sep 2014 · The Journal of Headache and Pain
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    • "On the other hand, the existence of a supportive non-smoking husband or another stable partner has a positive effect on the women being able to quit smoking during pregnancy. Marital status and number of children are the best investigated psychosocial factors for smoking during pregnancy, and our results are consistent with previous results showing that married women and women with no previous children have the lowest smoking prevalence [32,41]. Why having previous children was positively associated with continued smoking during pregnancy might be explained by the women’s personal previous experience of giving birth to a healthy child despite smoking during pregnancy, which creates distrust in the scientific evidence relayed by health professionals [43]. "
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    ABSTRACT: Background Some women continue smoking during pregnancy despite the extensive information available on the dangers smoking poses to their fetus. This study aimed to examine the prevalence and determinants of smoking before and during pregnancy and the extent of smoking during pregnancy from a European perspective in relation to maternal sociodemographic characteristics, health literacy, morbidity, and pregnancy-related factors. Methods This multinational, web-based study evaluated pregnant women and new mothers in 15 European countries recruited from October 2011 to February 2012. Data were collected via an anonymous online questionnaire. Results Of 8344 women included, 2944 (35.3%) reported smoking before pregnancy, and 771 (26.2%) continued smoking during pregnancy, 88 (11.4%) of whom smoked more than 10 cigarettes per day. There was a wide variation among the 15 European countries in smoking rates before and during pregnancy, ranging from 25.0% (Sweden) to 50.0% (Croatia) before and 4.2% (Iceland) to 18.9% (Croatia) during pregnancy. Women who lived in Eastern Europe, without a spouse/partner, with a low education level and unplanned pregnancy, who did not take folic acid, and consumed alcohol during pregnancy were the most likely to smoke before pregnancy. Women who lived in Eastern or Western Europe, without a spouse/partner, with a low education level and health literacy, being a housewife, having previous children and unplanned pregnancy, and who did not take folic acid were the most likely to continue smoking during pregnancy. Women who smoked more than 10 cigarettes per day during pregnancy were the most likely to be living in Eastern Europe and to have a low education level. Conclusion Women with fewer resources living in Western or Eastern Europe are more likely not only to smoke before pregnancy but also to continue smoking during pregnancy. These high-risk women are characterized as living alone, having high school or less as highest education level, having low health literacy, being a housewife, having previous children, having unplanned pregnancy, and no use of folic acid. Our findings indicated that focus on smoking cessation is important in antenatal care in Europe as many women smoke before pregnancy, and still continue to do so in pregnancy.
    Full-text · Article · Jun 2014 · BMC Pregnancy and Childbirth
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    • ") . Sie sind besonders empfänglich für sozialen Druck , den Vorstel - lungen , einer «guten Mutter» zu entsprechen und fühlen sich oft durch Andere verurteilt ( Ebert & Fahy , 2007 ) . Reine aufklärende und auf die Verantwortung der Frauen zielende Interventionen greifen hier zu kurz . "

    Full-text · Dataset · Apr 2014
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