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Denial of smoking‐related risk among pregnant smokers

Objective. To examine pregnant women's denial of risk, tobacco dependence and their partner's smoking status on smoking behavior during pregnancy. Design. Cross‐sectional design with convenience sampling. Setting. Data collection was carried out in hospitals and antenatal clinics in Budapest and 12 other Hungarian cities. Population or sample. A total of 406 adult pregnant women (mean age: 28.2 years; SD = 5.6) with a mean gestational age of 23.3 weeks ranging from 4 to 40 (SD = 8.9). Methods. Pregnant women were enrolled in the study by midwives and home‐care attendants. Main outcome measures. Smoking status was assessed by self‐report questions. Further measures included the Fagerstrom Test of Nicotine Dependence to assess nicotine dependence, and the Wisconsin Inventory of Smoking Dependence Motives to assess the motivational background of smoking. Risk perception was assessed by Haslam and Draper's (2000) 12‐item risk perception questionnaire. Results. Prevalence of occasional and daily smokers was 21.7 and 29.3%, respectively. Some 59.7% of the pregnant women have a partner who smokes. Daily smokers had a higher level of risk denial than occasional or non‐smokers (Welch F = 91.607; p < 0.001). Current smokers also had a higher denial than temporary quitters (t = ‐3.153; p = 0.003). Denial of risk correlated significantly with nicotine dependence (r = 0.30) and the main motivational factors (r = 0.34−0.48). A multinomial logistic regression model of denial of risk concurrently predicted women's smoking status (p = 0.001), even when controlling for age, education, partner's smoking status and parity. Conclusions. A higher level of risk denial seems to be one of the major determinants of women's smoking status during pregnancy.