Smoking during pregnancy: childbirth and health study in primary care in Iceland
Sammanfattning
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.