Improving smoking cessation support for pregnant women

In the Netherlands, 8% of pregnant women still smoke. Given the negative health effects of smoking for both mother and child, it is important that pregnant women receive optimal support to quit smoking. In this thesis, we gained insight into women's needs regarding smoking cessation support, the influence of smoking during pregnancy on healthcare utilization, the association between socioeconomic status and social relationships on smoking and/or drinking during pregnancy, and the impact of using e-cigarettes or tobacco cigarettes on health outcomes for mother and child. Finally, we implemented and evaluated the intervention to refer pregnant women to a coach from addiction care (Verslavingszorg Noord-Nederland, VNN) for smoking cessation support. We conclude that addressing smoking cessation among pregnant women is a challenge influenced by various factors. Referring pregnant women to VNN is an option to improve smoking cessation support. Smoking cessation support for pregnant women can be further optimized by ensuring that every maternity obstetric collaboration unit has a smoking cessation policy and adheres to this policy. Healthcare professionals and midwifery students should receive additional training in motivational interviewing to have the skills to discuss the smoking behavior of pregnant women appropriately. Future research should focus on the use of financial incentives, carbon monoxide meters, and e-cigarettes in supporting smoking cessation in pregnant women.