Degree Name

PhD (Doctor of Philosophy)



Date of Award


Committee Chair or Co-Chairs

Beth Bailey, William T. Dalton III

Committee Members

Russell W. Brown, Jon R. Webb, Andrea D. Clements


Smoking is the leading preventable cause of death, and smoking during pregnancy can lead to significant health complications for both the mother and developing child. In the Appalachian region of East Tennessee, pregnancy smoking rates are as high as 40% in some counties which is almost 4 times the national average. Weight and body image concerns have previously been identified as variables contributing to maintenance of smoking behavior. The current study was designed to examine the relationship between prepregnancy weight and body image concerns and smoking status at third trimester. Participants included 172 pregnant women who smoke. Women were recruited via Ob/GYN and Family Practice offices throughout East Tennessee and participating in the research arm of the Tennessee Intervention for Pregnant Smokers. Prepregnancy weight and body image concerns were assessed during first trimester via the Weight Concern Scale and Body Image Concern Inventory. Smoking status was collected at third trimester via self-report. At third trimester, 20% of participants reporting quitting since their first trimester visit. Logistic regression analyses revealed that education and weight concerns played a significant role in whether women chose to quit during pregnancy. Women with higher education were less likely to continue smoking (OR=.601, 95% CI .43-83, p=.003) and women reporting higher weight concerns were more likely to continue smoking (OR=1.67, 95% CI 1.23-2.27, p=.001). Beliefs about the weight control properties of cigarettes may play an important role in the decision to continue to smoke. These findings suggest the importance of assessing weight concerns and discussing weight gain with pregnant women who smoke in an effort to facilitate successful cessation.

Document Type

Dissertation - unrestricted


Copyright by the authors.