Perceptions of Smoking Health Risks During Pregnancy: Comparison of Smokers and Non-Smokers

Document Type


Publication Date



Smoking during pregnancy is not only harmful to the mother, but the unborn baby as well. In East Tennessee, smoking rates during pregnancy are more than three times the national average. Smoking cessation interventions have been shown to assist in lowering smoking levels during pregnancy. More successful intervention strategies may be developed if pregnant mothers’ beliefs on how smoking harms themselves and their child are examined and addressed. It was hypothesized that there is a significant difference between smoking status (smoker or non-smoker) and perceptions of the amount of harm smoking can cause to the baby, and to themselves. Participants included 577 pregnant women, both smokers and nonsmokers, enrolled in the Tennessee Intervention for Pregnant Smokers program. Participants met with a case worker during a first trimester interview, and answered several questionnaires. The questionnaires included several items regarding their perceptions of harm from cigarette smoking to their unborn baby and to themselves. For the overall analysis of differences in smoking status, participants who answered that smoking was “somewhat” or “no, not harmful at all” were compared to those that answered “yes, a great deal harmful”. Two Chi-square tests for independence indicated a significant association between smoking status and perception of how smoking harms the baby, χ2 (1, 578) = 65.85, p < .001, and a significant association between smoking status and perception of how smoking harms the participants’ heath χ2 (1, 578) = 26.07, p < .001. Non-smokers were more likely than smokers to answer that smoking is “yes, a great deal harmful” to the baby and to themselves. The results also suggest that participants as a whole, regardless of smoking status, believe that smoking is more harmful to themselves than to their unborn baby. Qualitative analysis revealed the top five categories of responses (most to least frequent) given by participants on how they believed smoking harmed their unborn baby: low birth weight, lung and respiration problems, premature birth, developmental problems, and birth defects. The most frequent responses given by participants on how they believed smoking was personally harmful were: lung and respiration problems, cancer, heart and blood problems, physical appearance concerns, and life expectancy or death. Non-smokers gave proportionally more responses overall than smokers. One interesting observation is that while smokers seemed aware of the risk of preterm birth and low birth weight, it was non-smokers who were more likely to state that smoking could cause developmental problems and birth defects. Perhaps cessation interventions would be improved by focusing on women’s perceptions of these possible consequences of smoking during pregnancy to their unborn child. This knowledge is beneficial because analyzing perceptions of harm from smoking could lead to more successful smoking cessation interventions during pregnancy.


Johnson City, TN

This document is currently not available here.