Home Institution

Washington and Lee University

Publication Date

Spring 2014

Program Name

Switzerland: Global Health and Development Policy


Smoking behavior during pregnancy is one of few preventable factors associated with poor health outcomes for both women and children. The post-communist countries in Central and Eastern Europe face many challenges in this realm, as tobacco control efforts have not adequately addressed this behavioral health issue that has arisen since 1989. To better inform these efforts in Romania, this study categorizes the determinants of pregnant women’s prior smoking, current smoking, and current smoke exposure by using both quantitative and qualitative analysis. We find that those living with other smokers, exposed to smoke on a daily basis, and experiencing stress during pregnancy are most at risk for harmful smoking behaviors. We suggest that future efforts involve both structural and service-based changes that are catered towards pregnant women. Structural changes include multi-sector integration for tobacco control, health system coordination and implementation of smoking cessation counseling, and improved monitoring of existing programs. Service-based changes include education programs, community-based efforts, and involving women’s partners in the smoking cessation process.


Community Health and Preventive Medicine | Maternal and Child Health | Public Health | Women's Health