Women's Knowledge, Attitudes, and Beliefs about Smoking During Pregnancy

Audience: Public health practitioners, clinicians, and policymakers working with women of childbearing age.

Key Points: Smoking during pregnancy increases the risk of adverse health outcomes for women and infants. Strategic cessation messages and policies are needed to reach women of childbearing age who smoke. We conducted 12 focus groups in four U.S. cities with women ages 18-30 (N=79) who were smokers and either planning pregnancy or recently pregnant.  Questions explored women’s knowledge, attitudes, and beliefs about adverse health outcomes associated with smoking during pregnancy and which outcomes might motivate them to quit. In light of the U.S. Food and Drug Administration’s plans to place graphic warning labels (GWLs) on cigarette packaging, we explored women's reactions about GWLs that depicted two adverse outcomes, a baby with cleft lip/palate and an infant born preterm. Data were analyzed using NVivo 8 software. Most participants knew that smoking during pregnancy causes adverse outcomes; few were aware of its association with cleft lip/palate. The majority believed that women should not smoke during pregnancy, but that it is acceptable to smoke prior to a positive pregnancy test. Outcomes that would motivate participants to quit included still birth and sudden infant death syndrome. Most women said that GWLs would motivate them to quit once they were pregnant.

Educational Experience: Presentation includes methods, findings, and conclusions.

Benefits: Findings can inform message development and U.S. policy efforts. Reaching all women of childbearing age with information about risks for adverse outcomes during the first trimester of pregnancy needs further exploration.