Smoking in pregnancy: a systematic review of qualitative research of women who commence pregnancy as smokers

Smoking in pregnancy is a socially-patterned risk. Women in disadvantaged circumstances are more likely to smoke prior to pregnancy; they are also less likely to quit in pregnancy and, among those who quit, more likely to resume smoking after birth.

While systematic reviews of randomised controlled trials have identified interventions that are effective in helping women to stop smoking in pregnancy, such reviews shed little light on the circumstances and experiences of smokers, or on the factors know to influence smoking and smoking cessation in pregnancy. We therefore undertook a systematic review of qualitative research to explore these issues.

Twenty six studies were included in the review, detailing experiences of over 600 pregnant women most of whom were from disadvantaged groups. The synthesis identified journeys taken by women who begin pregnancy as smokers, from being a /pre-pregnant smoker/ to being a /pregnant smoker /and the often-shifting changes in smoking behaviour throughout pregnancy through /quitting and/ /trying to quit /or/ continuing to smoke/. Our findings highlight how the circumstances of women’s lives influence their smoking behaviour, what facilitates quitting, and the barriers that women face.