Psychosocial resources and persistent smoking in early pregnancy--a population study of women in their first pregnancy in Sweden.

Abstract

Study objective -To test the stress hypothesis by characterising women during their first pregnancy who continue to smoke in early pregnancy in comparison with women who quit smoking, with special reference to psychosocial factors like social network, social support, demands, and control in work and daily life. Design -The study is based on a cohort of primigravidas followed during pregnancy. Data were collected by self administered questionnaires during the pregnant womens' first antenatal visit at about 12 weeks.Setting -The study was performed in the antenatal clinics in the city ofMalmo, Sweden.Participants -The participants were all primigravidas living in the city of Malmo, Sweden, over a one year period, 1991-92.A total of 872 (87.7%) of the 994 invited women agreed to participate. The population of this study on smoking includes all primigravidas who at the time of conception were smoking (n=404, 46.3%).Main results -At the first antenatal visit (63-6% (n =257) of the prepregnancy smokers were still smoking (a total smoking prevalence of 29-5%). The pregnant smokers were on average younger and had a lower educational level. The highest relative risk (RR) of continued smoking was found among unmarried women RR 2-7 (95% confidence interval) (1.5, 4.8), women having unplanned pregnancies RR 2-2 (1-2, 4.0) and those with a low social participation RR 1-6 (1.0, 2-7), low instrumental support RR 2-6 (1.2, 6.0), low support from the child's father RR 2-1 (1.0, 4.2) and those exposed to job strain RR= 2-3 (1.1,4-8). The In recent years great attention has been paid to the dangers of smoking during pregnancy. In spite ofthis, many pregnant women continue to smoke. In Sweden the prevalence of smoking among all pregnant women was 21 8% in 1992 (Swedish Medical Birth Registry -personal communication). A study from two big cities in Denmark showed a prevalence of 44% in 1987, and 81% ofthese women were still smoking at the end of pregnancy.9 One Norwegian study in 1989 showed a smoking prevalence of 46% 3 months before pregnancy, and 84% of the women were still smoking at the time of the first medical check up. '0 In a Swedish study, 32% of the pregnant women in one big city were daily smokers at the time of conception and by the time oftheir antenatal visit, 2 months later, 77% reported that they were still smoking."1 Women's smoking has been seen as related to social deprivation, stress, and disadvantage.2 13 Persistent smoking during pregnancy is found to be related to low household incomes, living in rented accommodation, being unmarried, and having a husband or partner in manual employment.'4 High parity number, not living with the infant's father, and daily passive smoking at home are also associated with an increased risk for continued smoking.'5 Other important predictors of unsuccessful smoking cessation are a high level of smoking before pregnancy and high coffee consumption.9Women experiencing depression and those with psychosocial difficulties in daily domestic roles also have higher rates of pe...

A survey of pregnant smokers’ interest in different types of smoking cessation support

“…However, the level of interest in NRT among these women is not known. Finally, research is required to investigate the relationship between psychosocial variables, such as self-efficacy [28] and social support for stopping smoking [35], and preferences for smoking cessation support among pregnant smokers.…”

828 – Smoking cessation in pregnant women with mental disorders: a cohort and nested qualitative study

“…However, women with mental disorders were more likely to be still smoking at delivery, as has been reported elsewhere. 9,10 The difficulties women with mental disorders have in stopping smoking may be related to limited encouragement and low rates of smoking discussions given by health professionals to all smokers beyond the initial opt-out offer (<8% recorded). Additional barriers may include giving a higher priority to mental health than smoking, found in both women and their maternity and mental health professionals in the qualitative study.…”

“…8 Continued smoking in pregnancy is associated with social disadvantage, low income, low education level, mental disorders, domestic violence and low levels of support. 9,10 In the UK, the social patterning of smoking throughout pregnancy is striking, with recent published self-report data varying between 3% and 30% in Westminster and Blackpool respectively. 4 Similarly, socioeconomic disadvantage is strongly associated with antenatal depression, 11,12 so it is unsurprising that almost 50% of pregnant smokers have depression or other common mental disorders.…”

Factors influencing the relationship between socioeconomic status and prenatal smoking.

“…These include parity (Lagerberg & Magnusson, 2013;Schneider, Huy, Schütz, & Diehl, 2010), marital/cohabitation status (Goodwin et al, 2007;Penn & Owen, 2002), second hand smoke exposure (SHS) Schneider et al, 2010), and stress (Crittenden, Manfredi, Cho, & Dolecek, 2007;Schneider et al, 2010). Depression (Linares et al, 2009;Meghea, Rus, & Rus, 2012), nicotine dependence (Crittenden et al, 2007;Meghea et al, 2012) and social support (Bullock, Mears, Woodcock, & Record, 2001;DeJin-Karlsson, Hanson, Ostergren, Ranstam, Isacsson, S ber g, 1996) were also linked with prenatal smoking.…”

“…Women who continue to smoke during pregnancy perceived more stress in their lives than those who quit (Haslam, Draper, & Goyder, 1997). Job strain (Dejin-Karlsson et al, 1996), financial stress (Bullock et al, 2001), parenting challenges, living in disruptive home environments, and lack of social support (Pletsch et al, 2003) are sources of stress that affect prenatal smoking status. Furthermore, factors known to be stressful, such as low education level , abuse (Jesse et al, 2006), low social support (Bullock et al, 2009), and neighborhood violence (Patterson et al, 2012), were all associated with prenatal smoking and low SES suggesting a relationship between SES and stress.…”