Smoking and smoking relapse during pregnancy and postpartum: Results of a qualitative study

Background: The purpose of this study was to describe women's smoking experience during pregnancy and postpartum. Primiparous women recruited during a randomized controlled trial to assess the effectiveness of postpartum visiting were invited to participate in a qualitative study. Methods: A semistructured protocol guided the face-to-face interview. Interviews were audiotaped and transcribed. Data were coded independently by the authors, and the final coding system for emergent themes was developed through a consensus process. Results: Of the 47 women invited to participate, 22 agreed to be interviewed. Three major themes emerged from the analysis: pregnancy as a context for stopping smoking, returning to smoking, and social pressures on smoking behavior. Concerns about the baby's health were cited as central reasons for stopping. Breastfeeding provided a reason for continued smoking cessation, whereas social events often demarcated a resumption of women's smoking choices. Conclusions: Results provide guidance for the timing and content of interventions to prevent smoking relapse.