title: Factors Associated With Quitting Among Smoking Pregnant Women From Small Town and Rural Areas in Poland.
abstract: BACKGROUND
  Smoking rates among women in Poland are high, and access to specialized smoking cessation services in rural areas are limited. The aim of this study was to assess factors related to quitting among pregnant women who smoke in rural areas of Poland.
  
  
  METHODS
  Data were collected during interviews conducted by midwives among 4512 women at various stages of their pregnancy. The interviews took place in small towns with populations having less than 8000 residents, located within 12 out of 16 voivodships (provinces). We used exhaled carbon monoxide to verify self-reported smoking status.
  
  
  RESULTS
  Overall, 38% of women interviewed (n = 1578) smoked before they found out they were pregnant. Among these women, 33% quit just after they had become aware of their pregnancy. The main predictors of early quitting were: higher educational attainment among pregnant women (adjusted odds ratio [AOR] 3.21; 95% confidence interval [CI] = 1.81-5.68), secondary educational attainment among their partners (AOR 1.63; 95% CI = 1.06-2.48), and not having children (AOR 1.71; 95% CI = 1.31-2.24). The main barriers to early quitting were: living with at least one current smoker (AOR 0.55, 95% CI = 0.39-0.76), being single (AOR 0.45; 95% CI = 0.29-0.71), and having both parents smoke cigarettes (AOR 0.67; 95% CI = 0.46-0.97).
  
  
  CONCLUSIONS
  A modest proportion of women included in this study quit after they became aware of their pregnancy. However, women faced multiple barriers to quitting, including the smoking status of their family members. The factors identified in the study can inform the design of tailored interventions for pregnant women in rural areas.
  
  
  CONCLUSIONS
  Smoking rates among women in Poland are high, and access to specialized smoking cessation services in rural areas are limited. This study found that women were motivated to quit smoking, and many quit after they had become aware of their pregnancy. However, women faced multiple barriers to quitting, including the smoking status of their family members. The factors identified in the study can inform the design of tailored interventions for pregnant women in rural areas.
authors.affiliation: Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Balwicki
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Smith
authors.affiliation: Department of Hygiene and Epidemiology, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Pierucka
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Maciej L
authors.initials: ML
authors.lastname: Goniewicz
authors.affiliation: Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Marzena
authors.initials: M
authors.lastname: Zarzeczna-Baran
authors.affiliation: National Health Fund, Warsaw, Poland.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Jedrzejczyk
authors.affiliation: Department of Obstetrics and Gynecological Nursing, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Marzena
authors.initials: M
authors.lastname: Strahl
authors.affiliation: Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Zdrojewski
mesh_terms: D000328:Adult; D001944:Breath Tests; D002248:Carbon Monoxide / Q000032:analysis; D004522:Educational Status; D005190:Family; D005260:Female; D006801:Humans; D017533:Marital Status; D009042:Motivation; D016017:Odds Ratio; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy; D037841:Pregnant People; D065840:Protective Factors; D012307:Risk Factors; D012424:Rural Population; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D002248:Carbon Monoxide