Access Type

Open Access Dissertation

Date of Award

January 2015

Degree Type


Degree Name




First Advisor

Steven J. Ondersma

Second Advisor

Emily R. Grekin


Tobacco is the most widely used drug of abuse during pregnancy. Despite efforts to reduce perinatal tobacco use, its prevalence has remained steady over at least the past decade, suggesting that efforts to reduce smoking prevalence before and during pregnancy have not been effective. Although a range of effective treatments exist, most pregnant smokers neither seek nor receive any kind of treatment. Complementary and alternative medicine (CAM) treatments may be ideal as alternative, low-cost approaches capable of reaching and assisting a greater proportion of pregnant women with smoking cessation. This study examined characteristics and treatment utilization practices of pregnant smokers in two national samples —the National Survey on Drug Use and Health and the National Health Interview Survey—in order to better understand the unique treatment needs and preferences of pregnant smokers, and to explore the prevalence and predictors of CAM use within this population. Results suggest that smoking in pregnancy is stable, but that several potentially modifiable factors that may help identify women who are at greater risk for persistent smoking during pregnancy, including smoking risk perception, current alcohol use, and factors related to nicotine dependence. Findings of this study also demonstrated that a sizeable proportion of pregnant smokers are already accessing CAM treatments, particularly among those of greater socioeconomic status. Further research is needed not only to validate the use of CAM treatments, but also to guide safety and treatment recommendations during pregnancy.