Attitude towards cessation among French pregnant smokers: Explaining the poor uptake of specialised support

ObjectivesThis study investigated pregnant smokers’ profile and attitude towards cessation to explain who stops smoking during pregnancy and who is unsuccessful.Study design682 pregnant smokers aged less than 50 had visited cessation services between 2004 and 2006. Pregnant smokers’ profile was described using: socio-demographic details, psychological and medical history, characteristics of tobacco consumption and details of cessation interventions. At the end of the first visit, cessation specialists could record a brief report of the visit with additional information on the smoker. Abstinence was verified during follow-up visits with expired carbon monoxide measures, with a threshold of 5 ppm. Associations between pregnant smokers’ profile and subsequent cessation interventions outcomes were tested using descriptive statistics. Predictors of cessation were determined with multivariate logistic regression. Reports of the visits were analysed by open coding to determine main themes.Results80.5% of women were heavy smokers at baseline whatever the intervention outcome (10 cigarettes or more per day by the first visit). 16.3% (N = 111) of women stopped smoking during their pregnancy. 59.8% (N = 408) were registered during a first visit but never returned to a cessation service. The reports revealed that these women showed little motivation for complete cessation, despite being offered an intervention plan. They were more interested in maintaining a reduced tobacco consumption for stress relief. Women who lived or worked with smokers feared that they would not be able to maintain abstinence.ConclusionsDespite being offered professional help, many pregnant heavy smokers do not feel ready to stop smoking. Their attitude towards cessation illustrates ambivalence. There is thus a need for coordinated efforts between antenatal care providers and smoking treatment specialists in order to enhance pregnant smokers’ motivation to quit.