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Keten Edis E, Keten M. Why women continue to smoke during pregnancy: a qualitative study among smoking pregnant women. Women Health 2023; 63:847-855. [PMID: 37905544 DOI: 10.1080/03630242.2023.2277314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023]
Abstract
Smoking during pregnancy is a serious public health concern due to its adverse consequences on fetal development and pregnant women's health. For the success of smoking cessation interventions, it is essential to determine why pregnant women continue smoking. The objective of this study is to determine the beliefs, attitudes, and barriers to quitting smoking during pregnancy. We adopted a qualitative research design. The participants consisted of 22 pregnant women who smoke, selected by purposive sampling. We collected data through semi-structured interviews and analyzed it using thematic analysis. We identified six themes namely "Reasons for starting to smoke: family and social environment," "Intention to quit smoking and related factors," "Smoking and emotional well-being," "Smoking and stressful life experiences," "Protective thoughts: reducing smoking to safeguard their babies," and "Belief in a healthy pregnancy and inadequate risk perception." Women expressed the desire to protect their fetus from the harm of smoking. However, they continued to smoke due to a lack of knowledge, inadequate risk perception, psychological difficulties, and lack of motivation. Health professionals should be aware of the difficulties experienced by pregnant women who smoke and should support them in quitting smoking.
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Affiliation(s)
- Elif Keten Edis
- Department of Nursing Faculty of Health Sciences, Amasya University, Amasya, Turkey
| | - Mustafa Keten
- Gaziosmanpaşa Public Health Center, Istanbul Provincial Health Directorate, İstanbul, Turkey
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Rahman T, Baker AL, Gould GS, Palazzi K, Lambkin D, Kennedy M. Factors Associated with Smoke-Free Pregnancy among Aboriginal and Torres Strait Women and Their Experience of Quitting Smoking in Pregnancy: A Mixed Method Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11240. [PMID: 34769756 PMCID: PMC8583423 DOI: 10.3390/ijerph182111240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/10/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022]
Abstract
Smoke-free pregnancies have long-term health benefits for mothers and babies. This paper quantitatively examines factors associated with smoke-free pregnancies among Aboriginal and Torres Strait Islander women (hereafter Aboriginal women) and qualitatively explores their smoking cessation (SC) experiences during pregnancy. An Aboriginal-led online cross-sectional study on SC was conducted with Aboriginal women and in partnership with Aboriginal communities, between July and October 2020. The present analysis includes participants who made a pregnancy-related quit attempt (N = 103). Chi-squared tests, logistic regression models, and thematic analysis of free-form text responses were performed. The adjusted odds of having smoke-free pregnancies were 4.54 times higher among participants who used Aboriginal Health Services (AHS) (AOR = 4.54, p-value 0.018). Participants living in urban settings had 67% lower odds of having smoke-free pregnancies compared to their regional/remote counterparts (AOR = 0.33, p-value 0.020). Qualitative data revealed strong motivations to reduce tobacco-related harms to the fetus and variability in quitting experiences at different stages of and across pregnancies. Smoking cessation care (SCC) can support Aboriginal women meaningfully if their quitting experiences are considered in SCC development and implementation. Consistent funding for AHS-led SCC is needed to garner health benefits for Aboriginal peoples. More research into urban versus regional/remote differences in maternal SC is recommended.
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Affiliation(s)
- Tabassum Rahman
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Amanda L. Baker
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Gillian S. Gould
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW 2450, Australia;
| | - Kerrin Palazzi
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - David Lambkin
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Michelle Kennedy
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
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Hunter A, Grech LB, Borland R, das Nair R, White SL, Marck CH. Barriers and motivators for tobacco smoking cessation in people with multiple sclerosis. Mult Scler Relat Disord 2021; 54:103085. [PMID: 34175666 DOI: 10.1016/j.msard.2021.103085] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 05/24/2021] [Accepted: 06/09/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Smoking is a key modifiable risk factor for health outcomes of people with multiple sclerosis (MS). Little evidence exists on whether the information and support needs of people with MS who smoke are met. This study aimed to explore knowledge, attitudes and beliefs about smoking and quitting, and quitting support needs in Australian people with MS. METHODS Current and recent smokers were recruited for phone interviews through social media and newsletters. Interview data were analysed in NVivo using framework analysis. RESULTS We interviewed 25 people with MS (20 current and five recent smokers). Many participants had little knowledge about the risks of smoking on MS progression. Some reported perceived benefits from smoking on MS symptoms, while others perceived smoking worsening their symptoms. Similarly, quitting was believed to have health benefits, but concerns about withdrawal symptoms and the impact on MS symptoms and relapses were common. Participants reported ambivalence discussing smoking with clinicians; some wanting more information and support, while also feeling shame or guilt. Many participants were asked about their smoking status by MS clinicians, however, the provision of evidence-based information, and referrals to quitting support services was very infrequent. General practitioners were often found helpful and supportive, but participants gave more weight to quit advice from MS clinicians. CONCLUSION Our results are the first to indicate that smoking cessation needs of Australian people with MS are not met. These findings should be confirmed in a larger sample, but there is potential to investigate whether implementing routine provision of brief advice in MS care, as a coordinated effort between MS researchers, practitioners, consumer advocates and behavioural intervention services, may meet these needs. Further, developing targeted resources and training quit counsellors to provide appropriate information and support specific to people with MS may improve smoking cessation success in people with MS.
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Affiliation(s)
- Assunta Hunter
- Disability and Health Unit, Centre for Health Equity, The Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Lisa B Grech
- Department of Health Sciences, Swinburne University, Melbourne, Australia; Melbourne School of Psychological Sciences, the University of Melbourne, Melbourne, Australia Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, United Kingdom; Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Clinical Sciences at Monash Health, Medicine, Nursing and Health Sciences, Monash University
| | - Ron Borland
- Melbourne School of Psychological Sciences, the University of Melbourne, Melbourne, Australia Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, United Kingdom; Cancer Council Victoria, Melbourne, Australia; The Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, Australia
| | - Roshan das Nair
- Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, United Kingdom; Institute of Mental Health, Nottingham, United Kingdom
| | - Sarah L White
- Quit Victoria, Cancer Council Victoria, Melbourne, Australia
| | - Claudia H Marck
- Disability and Health Unit, Centre for Health Equity, The Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
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Samson L, Hircsu I, Katko M, Bodor M, Gazdag A, Gazso AA, Kovacs B, Posta J, Balogh E, Mocsary P, Bhattoa HP, Nagy EV. Lower educational status interferes with maternal iodine intake during both pregnancy and lactation. Endocr Connect 2021; 10:742-749. [PMID: 34114967 PMCID: PMC8284948 DOI: 10.1530/ec-21-0166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/11/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate factors affecting conscious iodine intake among pregnant and lactating women in a rural area in Hungary. METHODS Pregnant women were studied and followed during lactation. Urinary and breast milk iodine concentration (UIC and MIC) were measured by inductively coupled plasma mass spectrometry. Potential interfering factors, including age, educational status and smoking were assessed. RESULTS During pregnancy and lactation, mild iodine deficiency was observed; median UIC were 66 and 49 µg/L, respectively. Educational status was found to be a strong determinant of both iodine nutrition and smoking status during pregnancy (P < 0.01 and P < 0.001) and lactation (P < 0.001 and P < 0.01). While smoking and non-smoking lactating mothers had similar concentrations of urinary iodine (median UIC: 47 and 51 µg/L, P = 0.95), the breast milk of smoking mothers contained less iodine (median MIC: 150 and 203 µg/L, P = 0.03). CONCLUSIONS Both low iodine intake and smoking contribute to the higher risk of iodine deficiency in women with lower educational status. In smokers, MIC is often low in spite of normal UIC, presumably due to the iodine transport blocking effect of the cigarette smoke towards breast milk; normal UIC may be misinterpreted as sufficient iodine supply towards the child. Antenatal health promotion strategies should focus on young women with lower educational status, even in regions where sufficient iodine intake has been achieved in non-pregnant adults.
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Affiliation(s)
- Laszlo Samson
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ildiko Hircsu
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Monika Katko
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Miklos Bodor
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Annamaria Gazdag
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Andrea Anett Gazso
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Bela Kovacs
- Institute of Food Science, University of Debrecen, Debrecen, Hungary
| | - Janos Posta
- Department of Forensic Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Eszter Balogh
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Peter Mocsary
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Endre V Nagy
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Correspondence should be addressed to E V Nagy:
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Pearson JL, Waa A, Siddiqi K, Edwards R, Nez Henderson P, Webb Hooper M. Naming Racism, not Race, as a Determinant of Tobacco-Related Health Disparities. Nicotine Tob Res 2021; 23:885-887. [PMID: 33822185 PMCID: PMC8496138 DOI: 10.1093/ntr/ntab059] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 12/14/2022]
Affiliation(s)
- Jennifer L Pearson
- Division of Social and Behavioral Health/Health Administration and
Policy, School of Community Health Sciences, University of Nevada,
Reno, USA
| | - Andrew Waa
- Department of Public Health, University of Otago,
Wellington, New
Zealand
| | - Kamran Siddiqi
- Department of Health Sciences, University of York,
York, UK
| | - Richard Edwards
- Department of Public Health, University of Otago,
Wellington, New
Zealand
| | | | - Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, National
Institutes of Health, Bethesda, MD,
USA
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