Family Practice © Oxford University Press 1992
Vol. 9, No. 4 Printed in Great Britain
Smoking Habits in Early Pregnancy and Attitudes Towards Smoking Cessation Among Pregnant Women and Their Partners Haug K, Aar0 LE and Fugelli P. Smoking habits in early pregnancy and attitudes towards smoking cessation among pregnant women and their partners. Family Practice 1992; 9: 494-499. One-hundred and eighty-seven general practitioners in western Norway recorded smoking habits among 2379 women, consulting for their first regular medical check-up in pregnancy. Forty-six per cent had been daily smokers the last 3 months before pregnancy. Thirty-nine per cent were still smoking at the time of their first check-up. Sixteen per cent of the daily smokers stopped smoking spontaneously during the first few weeks of pregnancy. Fifty-seven per cent of women younger than 20 and 28% of women 30 years and older, did smoke at the first check-up. Single women smoked more often than women living with a partner (58% versus 38%). Smoking habits were not associated with number of previous pregnancies. At the first check-up, 530 pregnant women, still smoking daily, 18-34 years of age, living with a partner, accepted to participate in a smoking intervention study. They filled in a questionnaire about their smoking habits, the smoking habits of their partners and their attitudes towards smoking cessation. Sixty-five per cent reported a reduction in their use of cigarettes after becoming pregnant. The mean reduction in the number of cigarettes smoked daily was 4.0 (31 %). Most of the respondents expressed a strong motivation to quit or reduce their smoking habits during their pregnancy. Seventy-two per cent of the partners were daily smokers. Reduction in the consumption of cigarettes, negative attitudes towards smoking and determination to stop smoking was significantly higher among women who were encouraged by their partners to stop smoking and in those who perceived that their partners were willing to reduce their consumption.
INTRODUCTION During the last 30 years a dose-response association between smoking and low birthweight has been documented in more than 45 studies.1 Smoking is known as the single most important cause of intrauterine growth retardation.2 Maternal smoking inCTeases the risk for spontaneous abortion,3 late fetal death,4 early neonatal death4 and sudden unexpected infant death.3 Smoking in pregnancy is also associated with childhood malignancies* and possibly with negative influence on the intellectual development of the offspring.7-8 Smoking intervention during pregnancy may have a major impact on female smoking prevalence, and consequently on the health of the women and their offspring. Pregnant women have a high rate of encounters with the health care system. This continuous • Division for Social Medicine, Department of Public Health and Primary Health Care, Ulriksdal 8c, N-5009 Bergen, •• Research Centre for Health Promotion, University of Beigen, Norway.
494
contact may offer an opportunity for smoking cessation. In their influential Theory of Reasoned Action, Ajzen and Fishbein9 emphasize personal attitudes as well as perceived social norms as the two main predictors of behavioural intentions as well as of actual behaviour. Their theory has been explicitly adapted to the study of smoking behaviour.10 As the present study focuses on pregnant women's attitudes towards smoking and on their partners' smoking habits, this corresponds well with the determinants of behaviour, as described in the theory of reasoned action. Smoking among significant others and own attitudes towards smoking have proven to be major factors behind smoking among adolescents." Smoking habits of partners correlate with the smoking habits of pregnant women.12*13 In smoking intervention programmes for pregnant women as well as in studies of smoking habits during pregnancy, the role of significant others in general and of partners in particular deserves increased attention.
Downloaded from http://fampra.oxfordjournals.org/ at Michigan State University on July 4, 2015
KJELL HAUG.* LEIF EDVARD AAR0** AND PER FUGELLI*
495
SMOKING HABITS IN EARLY PREGNANCY
The aims of this study were to investigate: (i) smoking habits in early pregnancy; (ii) spontaneous changes in smoking habits in early pregnancy; (iii) attitudes towards smoking cessation among pregnant, daily smoking women; and (iv) how the smoking habits of pregnant women are influenced by their partners' smoking habits and their encouragement for smoking cessation. MATERIALS AND METHODS In June 1986, 187 of 398 general practitioners (GPs) in western Norway accepted to participate in a study of pregnant, daily smoking women. The study started in November 1986 and ended in April 1989.14
Material Two Among the 2379 women, those who fulfilled the following criteria were invited to participate in a smoking cessation study: (i) age between 18 and 34 years; (ii) living with a partner; (iii) having smoked at least five cigarettes per day for the last 3 months before pregnancy; and (iv) still smoking at least one cigarette per day at the First medical check-up in pregnancy. One-hundred and forty-four pregnant women denied and 530 accepted to participate. The participants filled in a self-administered, non-anonymous questionnaire (five A4 pages) which focused on the smoking habits of the pregnant women and their partners and attitudes to smoking and smoking cessation during pregnancy. Statistical analyses were conducted on Statistical Package for the Social Sciences (SPSS/PC + V.4.0). Two-way cross tabulation with chi-square test for independence, one-way analysis of variance, two-way analysis of variance as well as /-test for correlated variables were applied. Significance was accepted at a 5% level (P < 0.05). RESULTS Material One For 1 year, each participating GP reported data from 12.7 pregnant women on average. Forty-six per cent of the women had been smoking daily for the last 3 months before pregnancy; 39% were still smoking daily at the first medical check-up in pregnancy. Sixteen per cent of the daily smokers had stopped smoking spontaneously while 0.5% (five women) had started smoking (Table 1).
Per cent daily smokers: Age
15-19 20-24 25-29 30 + Unknown All P
Vol. 9, No. 4 Printed in Great Britain
Smoking Habits in Early Pregnancy and Attitudes Towards Smoking Cessation Among Pregnant Women and Their Partners Haug K, Aar0 LE and Fugelli P. Smoking habits in early pregnancy and attitudes towards smoking cessation among pregnant women and their partners. Family Practice 1992; 9: 494-499. One-hundred and eighty-seven general practitioners in western Norway recorded smoking habits among 2379 women, consulting for their first regular medical check-up in pregnancy. Forty-six per cent had been daily smokers the last 3 months before pregnancy. Thirty-nine per cent were still smoking at the time of their first check-up. Sixteen per cent of the daily smokers stopped smoking spontaneously during the first few weeks of pregnancy. Fifty-seven per cent of women younger than 20 and 28% of women 30 years and older, did smoke at the first check-up. Single women smoked more often than women living with a partner (58% versus 38%). Smoking habits were not associated with number of previous pregnancies. At the first check-up, 530 pregnant women, still smoking daily, 18-34 years of age, living with a partner, accepted to participate in a smoking intervention study. They filled in a questionnaire about their smoking habits, the smoking habits of their partners and their attitudes towards smoking cessation. Sixty-five per cent reported a reduction in their use of cigarettes after becoming pregnant. The mean reduction in the number of cigarettes smoked daily was 4.0 (31 %). Most of the respondents expressed a strong motivation to quit or reduce their smoking habits during their pregnancy. Seventy-two per cent of the partners were daily smokers. Reduction in the consumption of cigarettes, negative attitudes towards smoking and determination to stop smoking was significantly higher among women who were encouraged by their partners to stop smoking and in those who perceived that their partners were willing to reduce their consumption.
INTRODUCTION During the last 30 years a dose-response association between smoking and low birthweight has been documented in more than 45 studies.1 Smoking is known as the single most important cause of intrauterine growth retardation.2 Maternal smoking inCTeases the risk for spontaneous abortion,3 late fetal death,4 early neonatal death4 and sudden unexpected infant death.3 Smoking in pregnancy is also associated with childhood malignancies* and possibly with negative influence on the intellectual development of the offspring.7-8 Smoking intervention during pregnancy may have a major impact on female smoking prevalence, and consequently on the health of the women and their offspring. Pregnant women have a high rate of encounters with the health care system. This continuous • Division for Social Medicine, Department of Public Health and Primary Health Care, Ulriksdal 8c, N-5009 Bergen, •• Research Centre for Health Promotion, University of Beigen, Norway.
494
contact may offer an opportunity for smoking cessation. In their influential Theory of Reasoned Action, Ajzen and Fishbein9 emphasize personal attitudes as well as perceived social norms as the two main predictors of behavioural intentions as well as of actual behaviour. Their theory has been explicitly adapted to the study of smoking behaviour.10 As the present study focuses on pregnant women's attitudes towards smoking and on their partners' smoking habits, this corresponds well with the determinants of behaviour, as described in the theory of reasoned action. Smoking among significant others and own attitudes towards smoking have proven to be major factors behind smoking among adolescents." Smoking habits of partners correlate with the smoking habits of pregnant women.12*13 In smoking intervention programmes for pregnant women as well as in studies of smoking habits during pregnancy, the role of significant others in general and of partners in particular deserves increased attention.
Downloaded from http://fampra.oxfordjournals.org/ at Michigan State University on July 4, 2015
KJELL HAUG.* LEIF EDVARD AAR0** AND PER FUGELLI*
495
SMOKING HABITS IN EARLY PREGNANCY
The aims of this study were to investigate: (i) smoking habits in early pregnancy; (ii) spontaneous changes in smoking habits in early pregnancy; (iii) attitudes towards smoking cessation among pregnant, daily smoking women; and (iv) how the smoking habits of pregnant women are influenced by their partners' smoking habits and their encouragement for smoking cessation. MATERIALS AND METHODS In June 1986, 187 of 398 general practitioners (GPs) in western Norway accepted to participate in a study of pregnant, daily smoking women. The study started in November 1986 and ended in April 1989.14
Material Two Among the 2379 women, those who fulfilled the following criteria were invited to participate in a smoking cessation study: (i) age between 18 and 34 years; (ii) living with a partner; (iii) having smoked at least five cigarettes per day for the last 3 months before pregnancy; and (iv) still smoking at least one cigarette per day at the First medical check-up in pregnancy. One-hundred and forty-four pregnant women denied and 530 accepted to participate. The participants filled in a self-administered, non-anonymous questionnaire (five A4 pages) which focused on the smoking habits of the pregnant women and their partners and attitudes to smoking and smoking cessation during pregnancy. Statistical analyses were conducted on Statistical Package for the Social Sciences (SPSS/PC + V.4.0). Two-way cross tabulation with chi-square test for independence, one-way analysis of variance, two-way analysis of variance as well as /-test for correlated variables were applied. Significance was accepted at a 5% level (P < 0.05). RESULTS Material One For 1 year, each participating GP reported data from 12.7 pregnant women on average. Forty-six per cent of the women had been smoking daily for the last 3 months before pregnancy; 39% were still smoking daily at the first medical check-up in pregnancy. Sixteen per cent of the daily smokers had stopped smoking spontaneously while 0.5% (five women) had started smoking (Table 1).
Per cent daily smokers: Age
15-19 20-24 25-29 30 + Unknown All P
