Stigma Attached to Smoking Pregnant Women: A Qualitative Insight in the General French Population

Abstract

Abstract Introduction Cigarette consumption during pregnancy has major health consequences for women and unborn children. The stigma of smoking during pregnancy might hinder mothers-to-be’s access to adequate healthcare and smoking cessation, especially in disadvantaged groups. This qualitative study was designed to describe extensively the public stigma associated with smoking during pregnancy. Aims and Methods Participants were French adults recruited from the general population through social networks (N = 100). They were asked to answer three pairs of open-ended questions regarding cognitions, emotions, and behaviors elicited in the general population by pregnant smoking women. An inductive thematic analysis was performed and interjudge agreement was computed on 30% of the corpus analyzed deductively. Finally, independence (chi-square) between themes and gender, education, parenthood, and smoking status was tested. Results Themes (n = 25) were defined regarding cognitions (n = 9, eg, irresponsible, thoughtless, and unmindful), emotions (n = 8, eg, anger and disgust), and behaviors, (n = 8, eg, inform and persuade, and moralize and blame). Global interjudge agreement was strong (κ = .8). No difference was observed in themes according to gender, parental status, or education, indicating a heterogenous awareness of stigma. However, some differences were observed according to smoking status (χ 2 = 69.59, p = .02) (eg, nonsmokers more frequently stressed immorality). Conclusions The stigma associated with smoking during pregnancy includes various components that might be measured and targeted in interventions to improve access to adequate healthcare and smoking cessation in this specific population. Implications This qualitative study explores the stigma that the general French population attaches to pregnant women who smoke. Themes regarding cognitions (eg, irresponsible, thoughtless, and unmindful), emotions (eg, anger and disgust), and behaviors (eg, inform and persuade, and moralize and blame) were identified. These themes could guide further research regarding scale development and antistigma interventions to support smoking cessation.