The effects of smoking in pregnancy: a review of approaches to behavioural change

A substantial body of evidence has now been accumulated which suggests that cigarette smoking during pregnancy can result in an increased incidence in the number of babies born of lower birth weight. There is also an increase in perinatal mortality in babies born to smoking mothers, as well as a higher incidence of spontaneous abortion, greater mortality and morbidity during the first year of life and a lower rate of growth and reduction in mental aptitude into late adolescence. Despite this compelling evidence it has been found that only a relatively small proportion of women who smoke actually stop when they become pregnant. It has been found that knowledge of the potential effects of smoking does not appear to exert a major influence on pregnant women's smoking behaviour. There is also relatively little research which addresses the reasons why some pregnant women continue to smoke during pregnancy. The issue is clearly complex and the evidence that does exist points to the need for health professionals to adopt more sophisticated interventions with pregnant women, which move beyond a simple educational approach.