The Pregnant Smoker Stigma Scale - Self Stigma (P3S-SS): development and validation in pregnant smoking women in France

ABSTRACT

Pregnancy smoking self-stigma may be associated with mental health and smoking cessation. This study aims to validate the Pregnant Smoker Stigma Scale – Self-Stigma (P3S-SS) assessing perceived and internalized stigma. Between May 2021 and May 2022, French pregnant smokers recruited online (n = 143) took the P3S-SS and other scales assessing depressive symptoms (EPDS), social inclusion (SIS), dissimulation, dependence (CDS-5), cessation self-efficacy (SEQ), and intention. The two versions of the scale include four dimensions: derogatory cognitions (“People think/I feel I am selfish”), negative emotions and behaviors (“People make me feel/smoking makes me feel guilty”), personal distress (“People/I feel sorry for me/myself”), and information provision (“People tell me/I think about the risks of smoking”). Confirmatory factor analyses and multiple regressions have been computed. Model fit was good for perceived stigma and internalized stigma (X2/df = 3.06, RMSEA = .124, AGFI = .982, SRMR = .068, CFI = .986, NNFI = .985; X2/df = 3.31, RMSEA = .14, AGFI = .977, SRMR = .087, CFI = .981, NNFI = .979). Controlling for dependence, cessation intention was positively predicted by perceived and internalized personal distress and negatively predicted by perceived negative emotions and behaviors (Adj R² = .143, F(8,115) = 3.567, p = .001). Controlling for dependence, dissimulation was positively predicted by internalized negative cognitions and perceived personal distress and negatively predicted by internalized personal distress (Adj R² = .19, F(9,98) = 3.785, p = .000). The P3S-SS opens up exciting avenues for further research. Stigma does not motivate women to stop smoking but increases distress and dissimulation.

KEYWORDS:

• Pregnancy smoking
• self-stigma
• smoking stigma

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/03630242.2023.2228929.

Additional information

Funding

This study was funded by the French National Cancer Institute [TABAC-2020-019]. The funder played no role in the study’s design, analysis, or interpretation of data, nor in the decision to submit the manuscript.