Smoking during pregnancy: Childbirth and Health Study in Primary Care in Iceland

Abstract

Objective. To study the prevalence and possible predictors for smoking during pregnancy in Iceland. Design. A cross-sectional study. Setting. Twenty-six primary health care centres in Iceland 2009–2010. Subjects. Women attending antenatal care in the 11th–16th week of pregnancy were invited to participate by convenient consecutive manner, stratified according to residency. A total of 1111 women provided data in this first phase of the cohort study. Main outcome measures. Smoking habits before and during early pregnancy were assessed with a postal questionnaire, which also included questions about socio-demographic background, physical and emotional well-being, and use of medications. Results. The prevalence of smoking prior to pregnancy was 20% (223/1111). During early pregnancy, it was 5% (53/1111). In comparison with women who stopped smoking during early pregnancy, those who continued to smoke had on average a significantly lower level of education, had smoked more cigarettes per day before pregnancy, and were more likely to use nicotine replacement therapy in addition to smoking during pregnancy. A higher number of cigarettes consumed per day before pregnancy and a lower level of education were the strongest predictors for continued smoking during pregnancy. Conclusion. The majority of Icelandic women who smoke stop when they become pregnant, and the prevalence of smoking during pregnancy in Iceland is still about 5%. Our results indicate stronger nicotine dependence in women who do not stop smoking during pregnancy. Awareness of this can help general practitioners (GPs) and others providing antenatal care to approach these women with more insight and empathy, which might theoretically help them to quit.

Key Words::

• Antenatal care
• childbirth and health
• general practice
• Iceland
• pregnancy
• primary health care
• smoking habits

Acknowledgements

The authors would like to acknowledge the steering committee of the Childbirth and Health Study.

Steering Committee of the Childbirth and Health Study

Johann A. Sigurdsson, Hildur Kristjansdottir, Olof Asta Olafsdottir and Thora Steingrimsdottir.

Declaration of interests

The study received support from the Research Fund of the Icelandic College of Family Physicians, the Primary Health Care of the Capital Area, Iceland, the Icelandic Midwifery Association Research Fund and the Landspitali (Icelandic National Hospital) University Hospital Research Fund.