Women's Perspectives on Smoking During Pregnancy and Factors Influencing Their Willingness to Quit Smoking in Pregnancy: A Study From the United Kingdom.

Objective This was a prospective questionnaire-based survey conducted in the Barnsley District of the United Kingdom among antenatal women smoking during pregnancy. The aim of the study was to assess the awareness of women regarding the risks with smoking during pregnancy, study their smoking behavior, their willingness to quit smoking during pregnancy, and the factors that could influence their intention to quit smoking. Methods A cohort of antenatal women smoking during pregnancy was surveyed prior to their contact with the maternity Stop Smoking Services. A well-structured, pre-tested, and validated questionnaire was used to assess their awareness regarding risks with smoking during pregnancy and their willingness to quit smoking during pregnancy. Descriptive statistics were used to analyze the results. Binomial logistic regression (univariate and multivariate) was used to identify the factors influencing the women's willingness to quit smoking during pregnancy. Results Among 66 women surveyed, 52 (79%) were multigravida and 14 (21%) were primigravida, with a mean age of 27.4 ± 5.7 years. Most women (68%) were in the first trimester of their pregnancy. Nearly two-thirds of women (64%) had low educational attainment, 53% were unemployed, 68% lived with family members who smoked, and 35% had mental health problems. One-third (33%) of women had an unsuccessful attempt at quitting smoking in the past. Around 44% of women had a low level of nicotine dependence, while 56% had a moderate level of nicotine dependence. More than three-fourths of women (77%) were aware that smoking during pregnancy is harmful for their baby, though most could not report the specific adverse effects. Nearly half of the women (51.5%) were willing to quit smoking during pregnancy with the rationality of having a healthy baby. On multivariate logistic regression analysis, awareness of the women that smoking during pregnancy has ill effects on the baby (adjusted odds ratio (aOR): 46.459, confidence interval (CI): 5.356-402.961, p value <0.001) was found to be the strongest predictor of willingness to quit smoking during pregnancy. Other determinants found to be significantly associated with willingness to quit smoking during pregnancy were unsuccessful quit attempts in the past (aOR: 0.048, CI: 0.007-0.309, p value 0.001) and the absence of any mental health concerns (aOR: 6.097, CI: 1.105-33.647, p value 0.038). Conclusion There is considerable room for raising awareness about the risks of smoking during pregnancy and providing effective smoking cessation and relapse prevention interventions in pregnancy. Obstetricians and midwives should actively participate in providing risk-focused information to pregnant women on smoking during pregnancy and support them in smoking cessation. Various factors such as employment status, nicotine dependence, previous failed attempts at quitting smoking, mental health issues, and awareness levels significantly influence the willingness to quit smoking during pregnancy. Hence, there is an imperative need to identify and address the barriers that could affect a woman's intention to quit smoking during pregnancy.