Smoking behaviors and abstinence in low-income pregnant women

Abstract

Background: Despite efforts to educate individuals about the hazards of smoking, pregnant women continue to smoke. In the literature, there is less evidence about successful abstinence strategies for low-income women. The purpose of this pilot study was to assess smoking behaviors and factors that support smoking abstinence in low-income pregnant women.

Methods: Using a longitudinal design, quantitative and qualitative data were collected from pregnant women at a low-income community prenatal clinic. Based on the Transtheoretical model, all subjects received information about the harmful effects of smoking and secondhand exposure, while current smokers were given a “quit kit” and contacted up to one year post-delivery to evaluate smoking behaviors.

Results: All subjects (N = 135) ranged in age from 18 to 41; 75% were not married; 78% had household incomes < $30,000; and the majority were African American (40%). Fifty-five (40.7%) never smoked while 77(57%) had a smoking history, of these 18(23%) were spontaneous quitters. Data indicated that 36% reported smoking during pregnancy, with the majority in pre-contemplation. After one year, 18% of current smokers quit.

Conclusions: Without a specific plan, the majority were unable to successfully abstain. Rate of abstinence may have been further influenced because subjects began smoking at an early age and were unsuccessful at previous quit attempts. Providers must continue to educate pregnant women but also evaluate strategies that require few provider visits, are cost effective, focus on relapse prevention, and can successfully influence smoking abstinence in low-income pregnant women.