title: Smoking cessation in pregnancy: psychosocial interventions and patient-focused perspectives.
abstract: BACKGROUND
  Smoking during pregnancy causes obstetric and fetal complications, and smoking cessation may have great benefits for the mother and the child. However, some pregnant women continue smoking even in pregnancy.
  
  
  OBJECTIVE
  To review the literature addressing the prevalence of smoking during pregnancy, explore psychosocial factors associated with smoking, and review the evidence of psychosocial interventions for smoking cessation during pregnancy in recent years.
  
  
  METHODS
  Computerized Internet search results in PubMed for the years spanning from 2004 to 2014, as well as references cited in articles, were reviewed. A search for the keywords "smoking cessation pregnancy" and "intervention" and "clinical trials" yielded 52 citations. Thirty-five citations were identified as useful to this review for the evidence of psychosocial interventions for smoking cessation during pregnancy.
  
  
  RESULTS
  The prevalence of smoking during pregnancy differs by country, reflecting the countries' social, cultural, and ethnic backgrounds. Women who had socioeconomic disadvantages, problems in their interpersonal relationships, higher stress, depression, less social support, and who engaged in health-risk behaviors were more prone to smoking during pregnancy. Psychosocial interventions, such as counseling, are effective methods for increasing smoking cessation.
  
  
  CONCLUSIONS
  Smokers may have various psychosocial problems in addition to health problems. It is important to understand each individual's social situation or psychosocial characteristics, and a psychosocial intervention focused on the characteristics of the individual is required.
authors.affiliation: Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: School of Health Sciences, Faculty of Medicine, Gunma University, Maebashi, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan.
authors.forename: Setsuko
authors.initials: S
authors.lastname: Imazeki
keywords: pregnancy; psychosocial intervention; smoking cessation; women’s health