Tuesday, 15 March 2016

Justifying smoking in pregnancy

Roger Watson, Editor-in-Chief

Smoking during pregnancy is known to be harmful to unborn babies, so why do some women persist? Smoking is also damaging to the smoker and to others in the vicinity, but surely - and especially - no mother wants to take the risk of harming her baby. So you would think!

The aim of the study reported in an article from Poland and published in JAN by Goszcyńska et al. (2016) was to study: 'lay justifications expressed by smoking pregnant women to explain why they use cigarettes during pregnancy and to determine a typology for these justifications' The article is titled: 'How do pregnant women justify smoking? A qualitative study with implications for nurses’ and midwives’ anti-tobacco interventions'.

An online forum was used and responses were analysed to see what the justifications were. One woman obviously thought 'so far so good' as she said: 'I’ve been smoking for the first trimester and nothing has happened to the baby, so still there’s no risk.' Another woman thought it was a matter of degree as she claimed: 'Nobody’ll dare to say out loud: ‘smoking while pregnant doesn’t harm’. But a teratogenic effect only happens if you smoke a packet a day. A cig won’t do harm.'

For some it seemed pointless to stop now; as one woman said: 'I’m 25 weeks pregnant. . ..It won’t make much difference if I quit now. There are already toxins in my body and it would take some time to get rid of them, about half a year.' Alternatively, everything causes cancer - so what's the point? 'Even fruits bought in stores contain so many chemicals and other rubbish. Should we give it all up during pregnancy? Smoking is said to cause cancer. What doesn’t cause cancer? Everything does!'

And, of course, people who justify the risk are always able to generalise from the particular.,.,.and miss the point: 'A friend smoked during pregnancy and gave birth to healthy twins. What’s important is that they’re loved and taken care of. Even a horrible stench won’t bother a child if it’s loved.'

Clearly some women are going to be difficult to convince about the benefits of not smoking during pregnancy. The authors conclude: 'The essence of the change required in current practice involves altering it into a dialogue with patients that aims to recognize and work on their specific justifications, which will augment their personal motivation to alter their behaviour.'

You can listen to this as a podcast.


GOSZCZYŃSKA E., KNOL-MICHAŁOWSKA K. & PETRYKOWSKA A. (2016) How do pregnant women justify smoking? A qualitative study with implications for nurses’ and midwives’ anti-tobacco interventions. Journal of Advanced Nursing doi: 10.1111/jan.12949

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