"Had I known the Effects; I would have Never Consumed it": Insights from Indian Pregnant Tobacco Users on Quitting

Tobacco use during pregnancy poses both immediate and long-term health risks to mothers and their fetuses/new-borns. International guidelines recommend psychosocial interventions to treat tobacco dependence during pregnancy. Tobacco cessation counseling, including brief advice by healthcare providers, has proven effective in supporting quit attempts. This article presents findings from a study conducted among pregnant tobacco users who received tailored behavior change interventions during routine antenatal care (ANC) check-ups. In-depth interviews of successful quitters (n = 9) were conducted during the postpartum period. The interviews were audio-recorded, transcribed, and translated into English. Inductive approach was used to code data, which was analyzed thematically by two researchers independently. Five key facilitators enabled successful tobacco cessation during pregnancy: improved risk perception through targeted counseling, uptake of culturally appropriate healthier alternatives, visible health benefits postquitting, strong social support from family members, and profound fear of harming the unborn child, which served as the primary motivator. ANC visits represent valuable opportunities to screen and counsel women tobacco users who are otherwise overlooked by the health system. Integrating tailored cessation counseling into routine maternal healthcare can effectively support quit attempts during this critical period, with potential for significant public health impact.