A survey of women who continue to smoke during pregnancy in Slovenia
More details
Hide details
Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
Slovenian Institute for Adult Education, Ljubljana, Slovenia
Publish date: 2018-10-02
Submission date: 2018-07-02
Final revision date: 2018-08-31
Acceptance date: 2018-09-20
Eur J Midwifery 2018;2(October):12
Smoking in pregnancy is unhealthy and can also have negative effects on the foetus. However, there are still some women who do not quit smoking during pregnancy. The aim of the study was to identify Slovenian women at risk who smoke during pregnancy.

A quantative approach using an online survey was adopted. The study was conducted in May and June 2017, in Slovenia. A snowball sample was used. Participation in the survey was anonymous and voluntary, and 118 women who identified themselves as smokers participated in the study. Descriptive statistics was used to analyse the data.

More than half (66%) did not quit smoking during pregnancy. Women who continued to smoke during pregnancy were usually younger, less educated with a partner who smoked. Women who smoked more cigarettes per day before conception were less likely to refrain from smoking during pregnancy. The most common reason for not quitting smoking during pregnancy was failure in attempts to quit (37%).

Women who smoke need support to stop smoking before pregnancy or, at least, in the first trimester. Special groups for smoking cessation need to be created. Further and more extensive research is warranted in Slovenia to assess this issue.

Polona Ana Mivšek   
Faculty of health sciences, Zdravstvena pot 5, 1000 Ljubljana, Slovenia
1. Koprivnikar H. Dejstva o škodljivosti kajenja. Ljubljana: Inštitut za varovanje zdravja Republike Slovenije; 2012: 6–13.
2. Koprivnikar H, Zorko M, Drev A, Keršmanc M H, Kvaternik I, Macur M. Uporaba tobaka, alkohola in prepovedanih drog med prebivalci Slovenije ter neenakosti in kombinacije te porabe. Ljubljana: Nacionalni inštitut za javno zdravje; 2015: 41–68.
3. Zakon o omejevanju uporabe tobačnih izdelkov. Accesed August 27, 2018.
4. Mesarič J, Novak Mlakar D, Hočevar T. Ste noseči, dojite ali načrtujete otroka? Zdaj je pravi čas, da opustite kajenje in živite v prostorih brez tobačnega dima. Ljubljana: Nacionalni inštitut za javno zdravje; 2014: 3–9.
5. Podlesnik Fetih A, Videmšek M, Vrtačnik Bokal E, Globevnik Velikonja V, Karpljuk D. Športna dejavnost, prehrana, razvade in psihično počutje nosečnice. Ljubljana: Fakulteta za šport, Inštitut za kineziologijo; 2010: 79–83.
6. Míguez MC, Pereira B, Figueiredo B. Tobacco consumption and spontaneous quitting at the first trimester of pregnancy. Addict Behav. 2017;64:111–7. doi: 10.1016/j.addbeh.2016.08.034
7. Kia F, Tosun N, Carlson S, Allen S. Examining characteristics associated with quitting smoking during pregnancy and relapse postpartum. Addict Behav. 2018; 78: 114–9. doi: 10.1016/j.addbeh.2017.11.011
8. O’Malley EG, Cawley S, Reynolds CME, Kennedy RAK, Molloy A, Turner MJ. Comparison at the first prenatal visit of the maternal dietary intakes of smokers with non-smokers in a large maternity hospital: a cross-sectional study. BMJ Open. 2018;8: e021721. doi: 10.1136/bmjopen-2018-021721
9. Bush T, Lovejoy J, Javitz H, Mahuna S, Jimenez Torres A, Wassum K, Magnusson B, Benedict C, Spring B. Implementation, recruitment and baseline characteristics: A randomized trial of combined treatments for smoking cessation and weight control. Contemp Clin Trials Commun. 2017;7:95–102. doi: 10.1016/j.conctc.2017.06.003
10. Wallace JL, Aland KL, Blatt K, Moore E, DeFranco EA. Modifying the risk of recurrent preterm birth: influence of trimester-specific changes in smoking behaviours. Am J Obstet Gynecol. 2017;216(Suppl 310):e1–8. doi: 10.1016/j.ajog.2016.11.1034
11. Smedberg J, Lupattelli A, Mardby AC, Nordeng H. Characteristics of women who continue smoking during pregnancy: a cross-sectional study of pregnant women and new mothers in 15 European countries. BMC Pregnancy and Childbirth. 2014;14(1):213.
12. Xu H, Ming Wen L, Rissel C, Baur LA. Smoking status and factors associated with smoking of first-time mothers during pregnancy and postpartum: findings from the healthy beginnings trial. Matern Child Health J. 2013;17(6):1151–7. doi: 10.1007/s10995-012-1108-6
13. Erlingsdottir A, Sigurdsson EL, Steinar Jonsson J, Kristjansdottir H, Sigurdsson JA. Smoking during pregnancy: Childbirth and health study in primary care in Iceland. Scand J Prim Health Care. 2014;32(Suppl 1):11–6. doi: 10.3109/02813432.2013.869409
14. Luger TM, Suls J, Vander Weg MW. How robust is the association between smoking and depression in adults? A meta-analysis using linear mixed-effects models. Addict Behav. 2014;39(10):1418–29. doi: 10.1016/j.addbeh.2014.05.011
15. Goodwin RD, Cheslack-Postava K, Nelson DB, Smith PH, Wall MM, Hasin DS, Nomura Y, Galea S. Smoking during pregnancy in the United States, 2005–2014: The role of depression. Drug Alcohol Depend. 2017;179:159–66. doi: 10.1016/j.drugalcdep.2017.06.021
16. Amasha HA, Jaradeh MS. Effect of active and passive smoking during pregnancy on its outcomes. Health Sci J. 2012;6(Suppl 2):335–52.
17. U. S. Department of Health and Human Services. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: A report of the Surgeon General. Atlanta, GA: U. S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010: 521–644.
18. U. S. Department of Health and Human Services. The health consequences of smoking: A report of the Surgeon General. Atlanta, GA: U. S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004: 525–610.
19. Matsuda Y, Hayashi K, Shiozaki A, Kawamichi Y, Satoh S, Saito S. Comparison of risk factors for placental abruption and placenta previa: Case-cohort study. J Obstet Gynaecol Res. 2011;37(Suppl 6):538–46. doi: 10.1111/j.1447-0756.2010.01408.x
20. Jaakkola JJK, Gissler M. Maternal smoking in pregnancy, fetal development, and childhood asthma. Am J Public Health. 2004;94(Suppl 1):136–40. doi:10.2105/ajph.94.1.136
21. Alverson CJ, Strickland MJ, Gilboa SM, Correa A. Maternal smoking and congenital heart defects in the Baltimore-Washington infant study. Pediatrics. 2011;127(Suppl 3):647–53. doi: 10.1542/peds.2010-1399
22. Goncalvez Leite IC, Koifman S. Oral clefts, consanguinity, parental tobacco and alcohol use: a case-control study in Rio de Janeiro, Brazil. Braz Oral Res. 2009;23(Suppl 1):31–7. doi:10.1590/s1806-83242009000100006
23. Marufu TC, Ahankari A, Coleman T, Lewis S. Maternal smoking and the risk of stillbirth: systematic review and meta-analysis. BMC Public Health. 2015; 15: 239–53. doi: 10.1186/s12889-015-1552-5
24. Kajenje škoduje zdravju. Ljubljana: Ministrstvo za zdravje. Published March 25, 2017. Accessd June 2,2018.
25. Zhang K, Wang X. Maternal smoking and increased risk of sudden infant death syndrome: a meta-analysis. Legal Medicine. 2013;15(Suppl 3):115–21. doi: 10.1016/j.legalmed.2012.10.007
26. Miller A. Maternal and perinatal health, mortality and statistics. In: Cooper MA, Fraser DM, editors. Myles Textbook for midwives. 15th ed. London: Churchill Livingstone; 2009:1061–71.
27. Ruhlman KJ. Smoking cessation during pregnancy: an evidence based practice protocol. http://digitalcommons.cedarvil.... Accesed July12,2017.
28. De Wilde KS, Tency I, Boudrez H, Temmerman M, Maes L, Clays E. The modified reasons for smoking scale: factorial structure, validity and reliability in pregnant smokers. J Eval Clin Pract. 2016; 22: 403–10. doi: 10.1111/jep.12500
29. Polen KND, Sandhu PK, Honein MA, Green KK, Berkowitz JM, Pace J, Rasmussen SA. Knowledge and attitudes of adults towards smoking in pregnancy: Results from the HealthStyles© 2008 Survey. Matern Child Health J. 2015;19:144–54. doi: 10.1007/s10995-014-1505-0
30. NIJZ (2017). Porodi v letu 2017. Accessed August 24, 2018.