CONFERENCE PROCEEDING
Experiences of pregnant women on receiving an integrated tobacco cessation service within the antenatal care services in rural India
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1
Health, Narotam Sekhsaria Foundation, Mumbai, India
2
Health, Ambuja Foundation, Mumbai, India
Publication date: 2025-06-23
Tob. Induc. Dis. 2025;23(Suppl 1):A517
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ABSTRACT
BACKGROUND: The Global Adult Tobacco Survey-2 (India) reports that 7.5% of pregnant women use tobacco, with a high prevalence of smokeless tobacco use in rural India. The lack of awareness and cessation support within antenatal care services often results in pregnant women continuing or initiating tobacco use during pregnancy, struggling to quit on their own.
METHODS: LifeFirst tobacco cessation service was integrated into the workflow of a rural community-based maternal and child health (MCH) program implemented by an NGO from May 2022 to April 2024. 98 women received cessation service during pregnancy and the postpartum period, of which 26 were selected using purposive sampling method, those reporting abstinence(13) and continued use(13) at the end of the intervention. Data saturation was attained. Implementation research frameworks guided the development of data collection tools and the framework method was employed for thematic data analysis.
RESULTS: Pregnancy was identified as a teachable moment leading to genuine quit attempts, requiring 3–6 months to achieve tobacco abstinence. Facilitators for abstinence included fear of adverse pregnancy outcomes, lack of withdrawal symptoms, support from spouse, and regret about not learning the harms earlier. Continued use was attributed to early initiation of tobacco consumption in adolescence, long-term habituation, influence from family members and spouse using tobacco, and previous failed quit attempts. Culturally appropriate tailored cessation support through community health workers who lived in the same village and consistency in monthly home visits increased the acceptability of the intervention.
CONCLUSIONS: Raising awareness among pregnant women and their communities is critical for initiating cessation efforts. Integrating accessible cessation services within antenatal care can reduce tobacco use, mitigate adverse pregnancy outcomes, and address the normalization of the use of locally prepared smokeless tobacco products. Scaling such interventions can significantly enhance maternal and child health outcomes.