How do pregnant women justify smoking? A qualitative study with implications for nurses’ and midwives’ anti‐tobacco interventions

Goszczyńska, Eliza; Knol-Michałowska, Kamila; Petrykowska, Alicja

doi:10.1111/jan.12949

Cited by 18 publications

(40 citation statements)

References 30 publications

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“…The results from the meta‐analysis indicate that exposure to prenatal cigarette smoking is associated with negative neurobehavioural outcomes in infants up to one year of age. Research indicates that not all women believe that smoking has negative behavioural consequences for their infant . Thus, examining neurobehavioural differences in smoke‐exposed and non‐exposed foetuses and infants is essential in order to convince pregnant women to abstain from cigarette consumption during their pregnancy and after birth.…”

Section: Discussionmentioning

confidence: 99%

“…Research indicates that not all women believe that smoking has negative behavioural consequences for their infant. 55 Thus, examining neurobehavioural differences in smoke-exposed and non-exposed foetuses and infants is essential in order to convince pregnant women to abstain from cigarette consumption during their pregnancy and after birth. For example, smoking during pregnancy may result in irritable infants which cry more than infants with a calm temperament.…”

Section: Con Clus Ionsmentioning

confidence: 99%

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Infant neurobehavioural consequences of prenatal cigarette exposure: A systematic review and meta‐analysis

2020

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Prenatal exposure to cigarette smoke has lasting postnatal effects including significant increased risk of cognitive impairment and learning difficulties. 1-3 Research suggests two specific toxins in cigarettes are causing these effects, namely carbon monoxide and nicotine. Carbon monoxide crosses the placenta binding to haemoglobin leading to a reduction in blood flow, ultimately impacting brain development and growth. 4 Similarly, nicotine readily crosses the syncytium, a thin layer of tissue separating maternal and foetal blood. 5 Although the foetal brain is protected from a range of neurotoxins, it is specifically sensitive to nicotine which targets specific neurotransmitters, leading to cell abnormalities and impaired foetal brain development by affecting synaptic activity. 5 Since nicotine affects brain development, it has the potential to affect neurobehaviour 6 including levels of excitability, negative affect, social orientation and regulation in infants. 7 However, there are a number of potential confounding factors that may influence human infant neurobehaviour, leading to difficulties in underpinning the contribution of cigarettes on the neurobehavioural outcome. Therefore, animal models provide an experimental paradigm to define the mechanisms of nicotine on neurobehaviour.

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Section: Discussionmentioning

confidence: 99%

Section: Con Clus Ionsmentioning

confidence: 99%

Infant neurobehavioural consequences of prenatal cigarette exposure: A systematic review and meta‐analysis

2020

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“…Indeed, physicians and medical students who themselves lead healthy lifestyles are more likely to have a positive influence on patients and help them to make healthy choices and lead healthy lives [ 8 , 9 , 10 ]. In addition, other healthcare professionals also provide counseling [ 11 ]. The World Health Organization has called on professional healthcare organizations to encourage and support their members to be role models by not using tobacco products and by promoting a tobacco-free culture [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Changes and specificities in health behaviors among healthcare students over an 8-year period

et al. 2018

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BackgroundHealthcare students are future health care providers and serve as role models and coaches to enhance behaviors for healthy lifestyles. However healthcare students face multiple stressors that could lead to adopting risk behaviors.ObjectivesTo assess the changes in health risk factors among healthcare students between 2007 and 2015, and to identify specific health behaviors based on the curriculum in a population of healthcare students:MethodsTwo cross sectionnal studies were conducted in 2007 and 2015 among nursing, medical, pharmacy, and physiotherapy students (Rouen, France). During compulsory courses and examination sessions students filled self-administered questionnaires on socio-demographic characteristics and behavior as: tobacco smoking, alcohol consumption, cannabis consumption, eating disorders, regular practice of sport, perceived health, stress and use of psychotropic drugs.Results2,605 healthcare students were included (1,326 in 2007 and 1,279 in 2015), comprising 1,225 medical students (47.0%), 738 nursing students (28.3%), 362 pharmacy students (13.9%), and 280 physiotherapy students (10.8%). Between 2007 and 2015, occasional binge drinking and regular practice of sport increased significantly among healthcare students, respectively AOR = 1.48 CI95% (1.20–1.83) and AOR = 1.33 CI95% (1.11–1.60), regular cannabis consumption decreased significantly, AOR = 0.32 CI95% (0.19–0.54). There was no change in smoking or overweight/obese. There was a higher risk of frequent binge drinking and a lower risk of tobacco smoking in all curricula than in nursing students. Medical students practiced sport on a more regular basis, were less overweight/obese, had fewer eating disorders than nursing students.ConclusionOur findings demonstrate a stable frequency of classic behaviors as smoking but a worsening of emerging behaviors as binge drinking among healthcare students between 2007 and 2015. Health behaviors differed according to healthcare curricula and nursing students demonstrated higher risks. As health behaviors are positively related to favorable attitudes towards preventive counseling, therefore healthcare students should receive training in preventive counseling and develop healthy lifestyles targeted according to the health curriculum.

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“…This review included 32 qualitative and mixed methods studies: twelve focused exclusively on the HPs’ perspectives [ 19 – 30 ], 16 exclusively on PW’s perspectives [ 31 – 46 ], while four papers included both [ 47 – 50 ]. Twenty studies were conducted in Europe [ 19 , 21 , 22 , 25 – 27 , 30 , 31 , 34 , 36 , 38 , 39 , 41 – 45 , 47 , 49 , 51 ], eight in the Oceania region [ 20 , 24 , 29 , 33 , 37 , 40 , 46 , 50 ], two in the USA [ 23 , 35 ] and one each in South America [ 48 ] and Africa [ 28 ]. HPs included doctors, nurses, midwives, Aboriginal Health Workers, pharmacists and other allied HPs.…”

Section: Resultsmentioning

confidence: 99%

Health providers’ and pregnant women’s perspectives about smoking cessation support: a COM-B analysis of a global systematic review of qualitative studies

Kumar

Stevenson

Jobling

et al. 2021

BMC Pregnancy Childbirth

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Background Smoking cessation in pregnancy has unique challenges. Health providers (HP) may need support to successfully implement smoking cessation care (SCC) for pregnant women (PW). We aimed to synthesize qualitative data about views of HPs and PW on SCC during pregnancy using COM-B (Capability, Opportunity, Motivation, Behaviour) framework. Methods A systematic search of online databases (MEDLINE, EMBASE, PsycINFO and CINAHL) using PRISMA guidelines. PW’s and HPs’ quotes, as well as the authors’ analysis, were extracted and double-coded (30%) using the COM-B framework. Results Thirty-two studies included research from 5 continents: twelve on HPs’ perspectives, 16 on PW’s perspectives, four papers included both. HPs’ capability and motivation were affected by role confusion and a lack of training, time, and resources to provide interventions. HPs acknowledged that advice should be delivered while taking women’s psychological state (capability) and stressors into consideration. Pregnant women’s physical capabilities to quit (e.g., increased metabolism of nicotine and dependence) was seldom addressed due to uncertainty about nicotine replacement therapy (NRT) use in pregnancy. Improving women’s motivation to quit depended on explaining the risks of smoking versus the safety of quit methods. Women considered advice from HPs during antenatal visits as effective, if accompanied by resources, peer support, feedback, and encouragement. Conclusions HPs found it challenging to provide effective SCC due to lack of training, time, and role confusion. The inability to address psychological stress in women and inadequate use of pharmacotherapy were additional barriers. These findings could aid in designing training programs that address HPs’ and PW’s attitudes and supportive campaigns for pregnant smokers.

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How do pregnant women justify smoking? A qualitative study with implications for nurses’ and midwives’ anti‐tobacco interventions

Abstract: The creation of a typology of lay justifications might help nurses and midwives perform more effective anti-tobacco interventions geared specifically towards the thought patterns typical of pregnant women.

Cited by 18 publications

References 30 publications

Infant neurobehavioural consequences of prenatal cigarette exposure: A systematic review and meta‐analysis

Infant neurobehavioural consequences of prenatal cigarette exposure: A systematic review and meta‐analysis

Changes and specificities in health behaviors among healthcare students over an 8-year period

Health providers’ and pregnant women’s perspectives about smoking cessation support: a COM-B analysis of a global systematic review of qualitative studies

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