Perceptions of African-American women about smoking during pregnancy: Results of focus groups

Background: Between 2000-2005 in Richmond, Virginia, infant mortality was 5 times higher among African American women than among whites. A social marketing campaign is being planned to address the problem. After a year of data gathering and strategic planning, a planning coalition has focused on reducing rates of maternal smoking. Focus groups were conducted to inform the campaign. Method: African American women between 18-44 who were pregnant or up to 24 months post-partum were recruited from clinics and community venues and given $50 gift certificates to participate. Peer outreach workers were trained as facilitators. Smoker, non-smoker, recent quitter and mixed groups (6 in all) were held in a public library. Questions reflected behavior change theory and the 4 “p's” of marketing. The groups were audio-taped, transcribed and theme-coded electronically. Results: Smokers associated smoking with “calming nerves” and drinking. Smoking triggers included friends and family who smoked and easy cigarette access. A lack of money was not seen as a barrier. The only opinions on their smoking women cared about were their own and those of their children. The health of the baby was considered an important reason to quit. Education and support groups were endorsed quitting aids, but the women did not think Richmond had such services. Smokers spoke of having been “blessed” if their babies were born healthy, but said God wanted women to help themselves. Media placement recommendations were made. Conclusions: Multi-channel messages about calling the free, evidence-based smoking quit-line will come from a child's perspective.