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Understanding Inequalities of Maternal Smoking—Bridging the Gap with Adapted Intervention Strategies

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  • Julie Boucher

    (Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, ON K1N 6N5, Canada)

  • Anne T. M. Konkle

    (Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, ON K1N 6N5, Canada
    School of Psychology, University of Ottawa, Ontario, ON K1N 6N5, Canada)

Abstract

Women who are generally part of socially disadvantaged and economically marginalized groups are especially susceptible to smoking during pregnancy but smoking rates are underreported in both research and interventions. While there is evidence to support the short-term efficacy of nicotine replacement therapy (NRT) use in pregnancy, long-term abstinence rates are modest. Current health strategies and interventions designed to diminish smoking in pregnancy have adopted a simplified approach to maternal smoking—one that suggests that they have a similar degree of choice to non-pregnant smokers regarding the avoidance of risk factors, and overlooks individual predictors of non-adherence. As a result, interventions have been ineffective among this high-risk group. For this reason, this paper addresses the multiple and interacting determinants that must be considered when developing and implementing effective strategies that lead to successful smoking cessation: socioeconomic status (SES), nicotine dependence, social support, culture, mental health, and health services. Based on our review of the literature, we conclude that tailoring cessation programs for pregnant smokers may ultimately optimize NRT efficacy and reduce the prevalence of maternal smoking.

Suggested Citation

  • Julie Boucher & Anne T. M. Konkle, 2016. "Understanding Inequalities of Maternal Smoking—Bridging the Gap with Adapted Intervention Strategies," IJERPH, MDPI, vol. 13(3), pages 1-16, March.
    • Handle: RePEc:gam:jijerp:v:13:y:2016:i:3:p:282-:d:65061
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    References listed on IDEAS

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    1. Wood, Lisa & France, Kathryn & Hunt, Kerry & Eades, Sandra & Slack-Smith, Linda, 2008. "Indigenous women and smoking during pregnancy: Knowledge, cultural contexts and barriers to cessation," Social Science & Medicine, Elsevier, vol. 66(11), pages 2378-2389, June.
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    Cited by:

    1. Gillian S. Gould & Alys Havard & Ling Li Lim & The PSANZ Smoking in Pregnancy Expert Group & Ratika Kumar, 2020. "Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators," IJERPH, MDPI, vol. 17(6), pages 1-34, March.
    2. Lisa McDaid & Ross Thomson & Joanne Emery & Tim Coleman & Sue Cooper & Lucy Phillips & Felix Naughton, 2021. "Agreement and Disparities between Women and Stop-Smoking Specialists about How to Promote Adherence to Nicotine Replacement Therapy in Pregnancy," IJERPH, MDPI, vol. 18(9), pages 1-16, April.
    3. Christi A. Patten & Kathryn R. Koller & Christie A. Flanagan & Vanessa Hiratsuka & Zoe T. Merritt & Flora Sapp & Crystal D. Meade & Christine A. Hughes & Paul A. Decker & Neil Murphy & Timothy K. Thom, 2019. "Postpartum Tobacco Use and Perceived Stress among Alaska Native Women: MAW Phase 4 Study," IJERPH, MDPI, vol. 16(17), pages 1-12, August.

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