Objectives: To determine: 1. the prevalence of regular smoking in the
latter half of pregnancy in a sample of Canadian prenatal patients; 2.
the psycho-social and demographic characteristics that differentiate
smoking from nonsmoking patients; 3. the characteristics that
differentiate prenatal patients who smoke more than 1O cigarettes per
day from those who smoke 1 to 10 cigarettes per day; and 4. the
psychiatric morbidities or psychological attitudes associated with
smoking in pregnancy.
Methods: Consecutive consenting women 20 or more weeks pregnant were
given, at a prenatal clinic, the General Health Questionnaire (GHQ), the
Fetal Health Locus of Control (FHLC), and a study questionnaire to
Results: Five-hundred and forty-five women completed the questionnaires.
Eighty-nine (16.3%) women reported regular daily cigarette smoking in
the second half of pregnancy, while 43 (7.9%) smoked more than 1O
cigarettes per day. Women who smoked were more likely than nonsmokers to
be under 21, born in Canada, have only elementary education, be
unemployed and unmarried, eat unhealthy diets, drink alcohol, use
nonprescription and illicit drugs, have unplanned pregnancies, histories
of emotional and physical problems, and have suffered physical abuse
before and during pregnancy. Smokers were more likely than nonsmokers to
meet case status on the GHQ and on the FHLC to believe `'chance'' and
less likely to believe that `'internal control'' or `'powerful others''
affected the health of their fetuses. `'Social disorganization'',
`'health risks'', and `'poor health'' factors accounted for 83.1% of
the total variance.
Conclusions: Women who smoke in pregnancy have a higher rate than
nonsmokers of other health risk behaviours, social disadvantage, and
emotional disturbance. Psychiatrists can play an important role in
identifying and treating emotional and psychiatric morbidity in women of
reproductive age to facilitate a reduction in smoking rates in this
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