OJN  Vol.4 No.11 , October 2014
The Lived Experience of Smoking in Pregnancy
Abstract: Smoking in pregnancy is associated with adverse pregnancy outcomes, such as low birth weight, preterm birth, and perinatal death. Despite widespread public awareness of the deleterious health effects of cigarette smoking, up to a quarter of women in developed countries smoke during their pregnancies. In this hermeneutic phenomenological study, the meaning and experience of smoking in pregnancy were explored. Data were collected through interviews with eight pregnant women from the Canadian province of Newfoundland and Labrador. Four main themes were identified in the participants’ stories, namely living in a smoking world, suddenly finding myself on a moral low road, navigating my own way to a high road, and not preparing for postpartum smoking pitfalls. Smoking was perceived to be salubrious and the participants painted a picture of dealing with smoking in pregnancy as a daunting, lonely endeavor that required life-altering solutions. With a better understanding of what smoking means to pregnant women who smoke, nurses can help these women forge a new and lifelong way to health and wellness.
Cite this paper: Murray, C. , Small, S. and Burrage, L. (2014) The Lived Experience of Smoking in Pregnancy. Open Journal of Nursing, 4, 762-773. doi: 10.4236/ojn.2014.411082.

[1]   Coleman, T., Chamberlain, C., Cooper, S. and Leonardi-Bee, J. (2011) Efficacy and Safety of Nicotine Replacement Therapy for Smoking Cessation in Pregnancy: Systematic Review and Meta-Analysis. Addiction, 106, 52-61.

[2]   Durmus, B., Kruithof, C.J., Gillman, M.H., et al. (2011) Parental Smoking during Pregnancy, Early Growth, and Risk of Obesity in Preschool Children: The Generation R Study. The American Journal of Clinical Nutrition, 94, 164-171.

[3]   Bjerg, A., Hedman, L., Perzanowski, M., Lundbäck, B. and Rönmark, E. (2011) A Strong Synergism of Low Birth Weight and Prenatal Smoking on Asthma in Schoolchildren. Pediatrics, 127, e905-e912.

[4]   Karmaus, W., Dobai, A.L., Ogbuanu, I., Arshard, S.H., Matthews, S. and Ewart, S. (2008) Long-Term Effects of Breastfeeding, Maternal Smoking during Pregnancy, and Recurrent Lower Respiratory Tract Infections on Asthma in Children. Journal of Asthma, 45, 688-695.

[5]   Håberg, S.E., Bentdal, Y.E., London, S.J., Kvaerner, K.J., Nystad, W. and Nafstad, P. (2010) Prenatal and Postnatal Parental Smoking and Acute Otitis Media in Early Childhood. Acta Paediatrica, 99, 99-105.

[6]   Murin, S., Rafii, R. and Bilello, K. (2011) Smoking and Smoking Cessation in Pregnancy. Clinics in Chest Medicine, 32, 75-91.

[7]   Nichter, M., Greaves, L., Bloch, M., et al. (2010) Tobacco Use and Secondhand Smoke Exposure during Pregnancy in Low- and Middle-Income Countries: The Need for Social and Cultural Research. Acta Obstetriciaet Gynecologica Scandinavica, 89, 465-477.

[8]   Public Health Agency of Canada (2009) What Mothers Say: The Canadian Maternity Experiences Survey. Public Health Agency of Canada, Ottawa.

[9]   Heaman, M.I. and Chalmers, K. (2005) Prevalence and Correlates of Smoking during Pregnancy: A Comparison of Aboriginal and Non-Aboriginal Women in Manitoba. Birth, 32, 299-305.

[10]   Muckle, G., Laflamme, D., Gagnon, J., Boucher, O., Jacobson, J.L. and Jacobson, S.W. (2011) Alcohol, Smoking, and Drug Use among Inuit Women of Childbearing Age during Pregnancy and the Risk to Children. Alcoholism: Clinical and Experimental Research, 35, 1081-1091.

[11]   Plaziac, C. and Hamel, D. (2007) Qanuippitaa? How Are We? Institut national de santé publique du Québec, Nunavik Regional Board of Health and Social Services, Quebec City.

[12]   Dietz, P.M., Homa, D., England, L.J., Burley, K., Tong, V.T., Dube, S.R. and Bernert, J.T. (2011) Estimates of Nondisclosure of Cigarette Smoking among Pregnant and Nonpregnant Women of Reproductive Age in the United States. American Journal of Epidemiology, 173, 355-359.

[13]   Graham, H. (1976) Smoking in Pregnancy: The Attitudes of Expectant Mothers. Social Science & Medicine, 10, 399-405.

[14]   Maclaine, K. and Macleod Clark, J. (1991) Women’s Reasons for Smoking in Pregnancy. Nursing Times, 87, 39-42.

[15]   Lawson, E.J. (2003) The Role of Smoking in the Lives of Low-Income Pregnant Adolescents: A Field Study. Adolescence, 29, 61-79.

[16]   Dunn, C.L., Pirie, P.L. and Lando, H.A. (1998) Attitudes and Perceptions Related to Smoking among Pregnant and Postpartum Women in a Low-Income, Multiethnic Setting. American Journal of Health Promotion, 12, 267-274.

[17]   Nichter, M., Nichter, M., Muramoto, M., Adrian, S., Goldade, K., Tesler, L. and Thompson, J. (2007) Smoking among Low-Income Pregnant Women: An Ethnographic Analysis. Health Education & Behavior, 34, 748-764.

[18]   Pletsch, P.K., Morgan, S. and Pieper, A.F. (2003) Context and Beliefs about Smoking and Smoking Cessation. The American Journal of Maternal Child Nursing, 28, 320-325.

[19]   Bull, L., Burke, R., Walsh, S. and Whitehead, E. (2008) The Perceived Effectiveness of Smoking Cessation Interventions Aimed at Pregnant Women: A Qualitative Study of Smokers, Former Smokers and Non-Smokers. Journal of Neonatal Nursing, 14, 72-78.

[20]   Haugland, S., Haug, K. and Wold, B. (1996) The Pregnant Smoker’s Experience of Ante-Natal Care: Results from a Qualitative Study. Scandinavian Journal of Primary Health Care, 14, 216-222.

[21]   McCurry, N., Thompson, K., Parahoo, K., O’Doherty, E. and Doherty, A.M. (2002) Pregnant Women’s Perception of the Implementation of Smoking Cessation Advice. Health Education Journal, 61, 20-31.

[22]   Haslam, C. and Draper, E.S. (2001) A Qualitative Study of Smoking during Pregnancy. Psychology, Health & Medicine, 6, 95-99.

[23]   Wigginton, B. and Lee, C. (2012) A Story of Stigma: Australian Women’s Accounts of Smoking during Pregnancy. Critical Public Health, 23, 466-481.

[24]   Lendahls, L., Öhman, L., Liljestrand, J. and Håkansson, A. (2002) Women’s Experiences of Smoking during and after Pregnancy as Ascertained Two to Three Years after Birth. Midwifery, 18, 214-222.

[25]   Edwards, N. and Sims-Jones, N. (1998) Smoking and Smoking Relapse during Pregnancy and Postpartum: Results of a Qualitative Study. Birth, 25, 94-100.

[26]   Abrahamsson, A., Springett, J., Karlsson, L. and Ottosson, T. (2005) Making Sense of the Challenge of Smoking Cessation during Pregnancy: A Phenomenographic Approach. Health Education Research, 20, 367-378.

[27]   Van Manen, M. (1990) Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Althouse, London.

[28]   Bergum, V. (1991) Being a Phenomenological Researcher. In: Morse, J., Ed., Qualitative Nursing Research: A Contemporary Dialogue, Sage, Newbury Park, 43-57.

[29]   Al-Sahab, B., Saqib, M., Hauser, G. and Tamim, H. (2010) Prevalence of Smoking during Pregnancy and Associated Risk Factors among Canadian Women: A National Study. BMC Pregnancy and Childbirth, 10, 24.

[30]   First Nations Information Governance Centre (2012) First Nations Regional Health Survey 2008/2010. First Nations Information Governance Centre, Ottawa.

[31]   Newfoundland and Labrador Provincial Perinatal Program (2008) Newfoundland and Labrador Provincial Healthy Baby Club Report-April 2001 to March 2006. Newfoundland and Labrador Provincial Perinatal Program, St. John’s.

[32]   Young, K. and Chatwood, S. (2011) Environmental Scan of First Nations, Inuit, and Métis Population Health Surveys. The Canadian Partnership against Cancer, Toronto.

[33]   Canadian Broadcasting Corporation (2013) Strategy Launched by Anti-Smoking Group.

[34]   Morse, J.M. and Field, P.A. (1995) Qualitative Research Methods for Health Professionals. Sage, Lon-don.

[35]   Kvale, S. (1983) The Qualitative Research Interview: A Phenomenological and a Hermeneutical Mode of Understanding. Journal of Phenomenological Psychology, 14, 171-196.

[36]   Meadows, L.M. and Morse, J.M. (2001) Constructing Evidence within the Qualitative Project. In: Morse, J.M., Swanson, J.M. and Kuzel, A.J., Eds., The Nature of Qualitative Evidence, Sage, Thousand Oaks, 188-201.

[37]   Morse, J.M., Barrett, M., Mayan, M., Olson, K. and Spiers, J. (2002) Verification Strategies for Establishing Reliability and Validity in Qualitative Research. International Journal of Qualitative Methods, 1, 13-22.

[38]   Heidegger, M. (1962) Being and Time. Harper & Row, New York.

[39]   Bottorff, J.L., Johnson, J.L., Irwin, L.G. and Ratner, P.A. (2000) Narratives of Smoking Relapse: The Stories of Postpartum Women. Research in Nursing & Health, 23, 126-134.<126::AID-NUR5>3.0.CO;2-2

[40]   Ribisl, K.M. and Jo, C. (2012) Tobacco Control Is Losing Ground in the Web 2.0 Era: Invited Commentary. Tobacco Control, 21, 145-146.

[41]   Robicsek, F. (1978) The Smoking Gods: Tobacco in Maya Art, History, and Religion. University of Oklahoma Press, Norman.

[42]   Wilbert, J. (1987) Tobacco and Shamanism in South America. Yale University Press, New Haven.

[43]   Harper, D. (2013) The Online Etymology Dictionary.

[44]   Bottorff, J.L., Kalaw, C., Johnson, J.L., Stewart, M., Greaves, L. and Carey, J. (2006) Couple Dynamics during Women’s Tobacco Reduction in Pregnancy and Postpartum. Nicotine & Tobacco Research, 8, 499-509.

[45]   Greaves, L., Poole, N., Okoli, C.C.T., et al. (2011) Expecting to Quit: A Best-Practices Review of Smoking Cessation Interventions for Pregnant and Post-Partum Women. Centre of Excellence for Women’s Health, Vancou-ver.

[46]   Bottorff, J.L., Kalaw, C., Johnson, J.L., Chambers, N., Stewart, M., Greaves, L. and Kelly, M. (2005) Unraveling Smoking Ties: How Tobacco Use Is Embedded in Couple Interactions. Research in Nursing & Health, 28, 316-328.

[47]   Greaves, L., Kalaw, C. and Bottorff, J.L. (2007) Case Studies of Power and Control Related to Tobacco Use during Pregnancy. Women’s Health Issues, 17, 325-332.

[48]   Bottorff, J.L., Oliffe, J., Kalaw, C., Carey, J. and Mroz, L. (2006) Men’s Constructions of Smoking in the Context of Women’s Tobacco Reduction during Pregnancy and Postpartum. Social Science & Medicine, 62, 3096-3108.

[49]   Thompson, L.E., Barnett, J.R. and Pearce, J.R. (2009) Scared Straight? Fear-Appeal Anti-Smoking Campaigns, Risk, Self-Efficacy and Addiction. Health, Risk & Society, 11, 181-196.

[50]   Hansen, J., Winzeler, S. and Topolinski, S. (2010) When Death Makes You Smoke: A Terror Management Perspective on the Effectiveness of Cigarette On-Pack Warnings. Journal of Experimental Social Psychology, 46, 226-228.

[51]   Churchill, A.C. and Davis, C.G. (2010) Realistic Orientation and the Transition to Motherhood. Journal of Social and Clinical Psychology, 29, 39-67.

[52]   Gadamer, H.G. (1989) Truth and Method. Continuum, New York.