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Control beliefs are related to smoking prevention in prenatal care


  • Conflict of interest: All authors report no potential conflicts of interest.


Dr. Sakari Lemola

Missionsstrasse 62a

4055 Basel





Smoking during pregnancy is one of the most important avoidable health risks for the unborn child. Gynaecologists and midwives play a fundamental role in the prevention of smoking during pregnancy. However, a large number of health care practitioners still do not address smoking in pregnant patients.


We examined whether gynaecologists and midwives engage in screening and counselling of pregnant women and conducting interventions to prevent smoking during pregnancy. Further, we examined the role of gynaecologists’ and midwives’ control beliefs. Control beliefs involve efficacy expectations – the practitioner's confidence in his capacity to conduct prevention efforts adequately – and outcome expectations – the practitioner's expectation that such prevention efforts are successful in general.


A total of 486 gynaecologists and 366 midwives completed a questionnaire on screening of smoking, counselling and other interventions they conduct to prevent smoking during pregnancy. Moreover, gynaecologists and midwives rated their control beliefs regarding their influence on pregnant patients’ smoking habits.


The majority of gynaecologists and midwives reported screening all pregnant patients regarding smoking, explaining the risks and recommending smoking cessation. By contrast, only a minority engages in more extensive prevention efforts. Strong control beliefs were predictive of a higher likelihood of screening and counselling, as well as of engaging in more extensive interventions.


The findings point to the importance of strengthening gynaecologists’ and midwives’ control beliefs by professional education and training on smoking prevention.