Context and beliefs about smoking and smoking cessation.

Purpose: To describe the context of, and beliefs about, smoking cessation in a sample of low-income African American pregnant women.

Study Design & Methods: A naturalistic descriptive qualitative approach was used with 15 women. Face-to-face interviews were conducted using a semi-structured interview guide. Interviews were transcribed verbatim and a thematic content analysis conducted. Perinatal health complication data were extracted from the participants' medical records and summarized.

Results: Two major themes were identified. The context of smoking cessation theme was Living the Stressful Life, with subthemes of Personal and Community Stress, Personal Health Problems, and Smoking For Stress Management. The second major theme was Personal Accountability for Smoking Cessation. There was a mismatch between women's sources of stress (which were out of their control) and their perceived locus of change (which was personal behavior).

Clinical Implications: To improve the outcomes of tobacco control programs for low-income women, we need to take action to create healthier communities.