The Effects of Nicotine Addiction on Women's Smoking Status During Pregnancy and on their Success in Smoking Cessation

Introduction: The difficulty of pregnant smokers in quitting smoking is affected by many psychosocial factors. However, it seems that the degree of nicotine addiction has a very important aggravating factor for the success of smoking cessation. Nicotine addiction should therefore be thoroughly investigated and this can be achieved by using reliable tools to measure the extent of this dependence. This gives the opportunity of personalized adjustments, depending on the result, on the smoking cessation intervention plan that will be employed to help each pregnant smoker. Aim: The investigation, through a systematic review of the international literature, of the effect that the degree of nicotine addiction has on the smoking status of women during pregnancy, as well as on the overall success of smoking cessation. Material and Method: A search for articles was conducted in the “Scopus” electronic database, using the following keywords: "smoking", "pregna*", "nicotine addiction", "fagerstrom" individually and in combination with one another. The inclusion criteria defined for the review were the following: (a) research to be published in the last 10 years, (b) research to be primary, (c) research to be published in English or Greek, (d) the sample to consist of adults. Results: A first review of the literature initially identified a total of 101 studies, of which 4 were finally selected. The analysis of the studies found that pregnant smokers who have an increased rate of nicotine addiction are essentially those who continue to smoke daily during pregnancy and at the same time those who also refuse to accept that smoking during pregnancy can pose great risks to both themselves and their fetus. In addition, by measuring the degree of nicotine addiction with the measuring tools we have today, not only can we predict the smoking status, but also the success rate of smoking cessation. We cannot however predict a potential relapse in the future. Conclusions: The results from the use of nicotine addiction calculation tools such as the "six-item Fagerström Test for Cigarette Dependence (FTCD)", the "Heaviness of Smoking Index (HSI)" and the "five-item Cigarette Dependence Scale (CDS-5)”, can be used appropriately in order to adopt a more personalized smoking cessation plan for every pregnant smoker, which will better suit both their particular degree of nicotine addiction, and their individual special needs.