© 1997 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom
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The pregnant smoker: a preliminary investigation of the social and psychological influences
C. Haslam, Lecturer in Psychology
E. S. Draper, Research Fellow in Perinatal Epidemiology
E. Goyder, Medical Research Council Training Fellow in Health Services Research
Department of Human Sciences, Loughborough University Loughborough, Leicestershire LEU 3TU
Department of Epidemiology and Public Health, Leicester University 22–28 Princess Road West, Leicester LEI 6TP
Address correspondence to Dr C. Haslam
BACKGROUND: Smoking during pregnancy is an important challenge to public health. An understanding of the psychological and sociological bases of maternal smoking is essential tothe development of effective smoking cessation interventions. The aim of this study was to explore the psychosocial factors that underpin maternal smoking.
METHODS: Semi-structured interviews were conducted with 200 antenatal attenders atLeicester Royal Infirmary, NHS Trust, UK.
RESULTS: Twenty-nine per cent were smokers, 22 per cent ex-smokers and 49 per centwere never smokers. Around half of the ex-smokers (49 per cent) had reportedly given up smokingduring 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; 
< 0.001). There was no difference in the level of knowledge about the dangers of maternal smoking between smokers, ex-smokers and never smokers.
CONCLUSIONS: 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.
Keywords: smoking, pregnant women, interviews
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