Lived experiences of young pregnant women who smoke
Smoking tobacco during pregnancy can lead to adverse pregnancy and child health outcomes.
To gain insight of smoking during pregnancy from young pregnant women's lived experience.
A descriptive phenomenological approach was used. Semi-structured interviews were conducted with five women aged 18-20 years who had smoked tobacco during pregnancy.
Themes that emerged from the data were related to culture and routine, psychological wellbeing, self-efficacy, public opinion, recognition of harm, whom they spoke to about smoking, and the approaches that helped behaviour change.
Midwives were seen as the trusted health professional by the young women and a non-judgemental approach was valued to promote self-efficacy. Smoking cessation services were not recognised as beneficial, and cutting down, rather than using nicotine replacement therapy or e-cigarettes, was preferred.
Smoking tobacco during pregnancy contributes to numerous adverse pregnancy outcomes (Salihu and Wilson, 2007; Marufu et al, 2015). Early life influences later health outcomes and exposure to problems in fetal growth may lead to higher risks of disease in adult life (Gluckman et al, 2008; Eriksson, 2010; Sipola-Leppänen et al, 2015).
Women who smoke during pregnancy tend to be younger and from lower socioeconomic groups (Hiscock et al, 2012; NHS Digital, 2012). Despite a steady decline in the number of pregnant women in England who smoke, from 15.8% in 2006/7 to just under 11% in 2017/18 (NHS Digital, 2018), younger women are least likely to stop smoking, with only 38% reporting any cessation (NHS Digital, 2012). Two systematic reviews have found that smoking cessation interventions for pregnant women were effective and significantly reduced smoking in late pregnancy (Lumley et al, 2009; Chamberlain et al, 2013); however, it is unclear whether this applies to younger women, as only two studies in the above reviews specifically considered women aged 20 years old or younger. The first (Albrecht et al, 1999) may be less applicable in today's context, although their more recent study (Albrecht et al, 2006) demonstrated that for those aged between 14 and 19 years, cognitive behavioural therapy (CBT) combined with peer support from a non-smoking friend had significantly more effect than the usual care provided to the control group.
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