Qualitative study on the perception of combustible cigarettes, e-cigarettes and heated tobacco cigarettes among pregnant women.

The research proposes to investigate the psychological reasons that may explain women's addiction to smoking during pregnancy and the perception of combustible cigarettes, electronic cigarettes and heated tobacco cigarettes. The sample included 30 participants who smoke or people who previously smoked who chose to quit or continue smoking during pregnancy. The data was gathered via a semi-structured interview and developed from three research questions: feelings, opinions and perceptions of pregnant women toward e-cigarettes, heated tobacco cigarettes, and combustible cigarettes. The study used thematic qualitative analysis for the methodological formulation of the results. The Standards for Reporting Qualitative Research Standards (QRRS) checklist was used. In this qualitative research, three psychological reasons for the onset of smoking were found and analyzed: feelings of stress, nervousness, and loneliness. According to the results: 40.91% of the women who smoked combustible cigarettes decided to keep on smoking and 59.09% decided to quit, 16.67% of participants who use heated tobacco cigarette decided to continue during pregnancy and the remaining 83.33% decide to stop; lastly, there is a condition of fairness for adults who use e-cigarette, 50% decided to continue smoking during pregnancy and the other 50% decided to stop smoking. The data indicate that those who continue to smoke during pregnancy are participants who smoke combustible cigarettes, stating that they reduce the amount of smoke inhaled. Meanwhile, participants who use heated tobacco cigarettes or e-cigarettes are certain that they pose less risk than combustible cigarettes; nevertheless, most of them decide to quit smoking during pregnancy. Another important aspect that has been noted is that of formal abandonment treatments, as quite unexpectedly, there has been a unanimous recognition of strong distrust toward the possible risks to the unborn child. There is a lot of distrust and little knowledge of official smoking cessation therapies, and because of this, participants stated that they can quit smoking whenever they want and only with their own willpower. Five categories and related themes emerged from the thematic analysis, such as reasons for starting with themes such as stress, irritation, loneliness, adolescence and integration; reasons for attachment to topics such as habit and carelessness about one's health; perceptions of traditional cigarettes compared to e-cigarettes and heated cigarettes with related topics such as sensory experiences and side effects; feelings and use of official smoking cessation therapies with issues as willpower and knowledge; information on the effects of smoke during pregnancy and breastfeeding, including risk information.