A comparative analysis of smoking status among the Roma and the general population during pregnancy: The critical role of midwives in smoking cessation

INTRODUCTION Tobacco consumption poses severe health risks, particularly for pregnant women, where it exacerbates maternal and fetal morbidity and mortality. This issue is especially critical among minority groups such as the Roma, who face unique socio-economic and cultural challenges that contribute to higher smoking rates. This study investigates the smoking behaviors of pregnant Roma women and the general population, highlighting the role of midwives in smoking cessation. METHODS The study involved 142 pregnant women, split equally between Roma women from specific regions in Greece and their counterparts from the general population in 2023. We conducted data collection through multiple site visits, utilizing a comprehensive questionnaire that covered aspects like tobacco use, exposure to passive smoking, and the role of midwives. We performed statistical analysis using SPSS, focusing on differences between the two groups using chi- squared tests and linear regression analyses. RESULTS We noted significant differences between the groups in age, education level, income, and living conditions (p<0.05). The Roma participants displayed a higher prevalence of smoking during pregnancy (76% vs 54.9%, p=0.018). A higher proportion of the Roma group exhibited moderate to high nicotine dependence compared to the non-Roma group, with 27.8% having moderate and 24.1% having high nicotine dependence (p=0.029). The study also found that Roma women are less likely to have structured healthcare support (17.2% had monitoring from a specific doctor compared to 78.9% of non-Roma, p=0.020) and more likely to engage midwives in discussions about smoking cessation (56.5% vs 48.7%, p=0.024). CONCLUSIONS The findings emphasize the need for culturally informed healthcare interventions that enhance the training of midwives in smoking cessation techniques. Such approaches are vital for improving health outcomes for pregnant women within marginalized communities like the Roma, where socio-economic and cultural barriers significantly influence health behaviors.