Prevention of Smoking During Pregnancy: A Systematic Review of the Literature

Abstract

Pregnancy constitutes a period of increased vulnerability. When a pregnant woman smokes, this vulnerability is amplified, leading to severe consequences for both her health and that of the fetus, during pregnancy, childbirth, and after birth. It therefore becomes imperative to develop and implement appropriate strategies aimed at preventing smoking within this specific population. Method: A systematic literature review was conducted using the PubMed and Google Scholar databases to identify various strategies and interventions developed to prevent smoking during pregnancy. The literature search was performed by combining the keywords "intervention"/"prevention," "smoking," and "pregnancy." Using the Boolean operators AND/OR, the following search equations were constructed: "intervention" OR "prevention" AND "smoking" AND "pregnancy" on Google Scholar, as well as "intervention" OR "prevention" AND "smoking" AND "pregnancy" on PubMed. Results: The results indicate that 73.3% of the interventions deployed proved effective in preventing smoking among pregnant women, while 26.7% demonstrated ineffectiveness. The identified preventive approaches include notably: training, information, and awareness; financial incentives for pregnant women who maintained abstinence; physical exercise; the use of nicotine substitutes or tobacco alternatives; exogenous administration of progesterone; adoption of the behavioral model developed by Prochaska and DiClemente as well as the Anglo-Saxon "5 A's" model; total prohibition of any form of tobacco-positive advertising; peer counseling; and the use of positive social influences promoting smoking cessation. Discussion: The majority of interventions (3 out of 15) are primarily based on training, information, and awareness of pregnant women. Prevention fundamentally relies on clear communication regarding health risks as well as a better understanding of tobacco dependence. This approach corresponds to what the World Health Organization designates as a reverse marketing campaign. It should finally be emphasized that ignorance remains the main factor favoring the continuation of smoking during pregnancy.