(PS1-45) Pregnant Individuals’ Beliefs Regarding Simultaneous Smoking Cessation and Substance Use Treatment on Agreement with Health Risk to Fetus

Smoking is considered the most challenging addictive behavior to quit, even more so than alcohol or opioid use. About 7% of individuals smoke during pregnancy, which is associated with adverse outcomes for mother and child. Current smoking cessation interventions in pregnancy use psychoeducation on the risk of smoking to the individual and child. Education and behavior modification is recommended with high certainty for tobacco cessation effectiveness. However, intervention efficacy for pregnant individuals is limited as only 25% of individuals stop smoking for any period during pregnancy. Even more concerning are the rates of smoking in pregnant individuals with substance use disorders. Prevalence estimates suggest up to 80% of pregnant individuals smoke, rates of smoking cessation are minimal, and relapse is common. Thus, improved smoking cessation interventions are needed for this high-risk population and tailored interventions incorporating other factors (e.g., stress management) may increase quit and long-term cessation rates for pregnant individuals with substance use disorder.

In the current study, pregnant smoking individuals (N=36) receiving substance use treatment and perinatal medical care in a specialized obstetric medication-assisted therapy clinic reported their experience quitting smoking during substance use treatment. Participants rated their agreement with several identified health risks of smoking during pregnancy using a 5-point Likert scale (lower scores indicated greater agreement). Participants also rated the following statements as true or false: 1) it is difficult to simultaneously quit smoking and substances while pregnant [76% endorsed true], 2) quitting nicotine poses a risk to my sobriety [58% true], and 3) I use nicotine to cope with substance cravings and urges [39%]. Analyses found no significant differences on the participants’ endorsement of smoking during pregnancy health risks between individuals who rated the above items as true vs false (ps > .05).  All health risk means ranged from 1.51 to 1.80, indicating pregnant smoking individuals receiving substance use treatment recognized the risks of smoking during pregnancy.

Findings add to the literature about smoking cessation in pregnant individuals who use substances. Psychoeducation about health risks of smoking while pregnant are important, but other concerns exist that intersect with their substance use recovery efforts as they also attempt to quit smoking.  Refining our intervention for this high-risk population needs to address these concerns.