From fetal health to women’s health: expanding the gaze on intervening on smoking during pregnancy

Smoking during pregnancy has long been a preoccupation of public health, eclipsing and delaying attention to women’s smoking and women’s health. Despite decades of intense attention within tobacco control to smoking and pregnancy, there have been few effective interventions developed with women who are pregnant and smoke and persistently high rates of relapse postpartum. We argue that a history of fetus-centric, individually oriented, decontextualized approaches have deterred interveners from developing transformative, women-centred approaches that are reflective of women’s situations, social context, and experiences. Interventions are needed that reorient and extend the stance of practitioners, reduce stigma, provide more integrated responses to women, and address the inequities reflected in tobacco use patterns especially among young women, women with experiences of trauma, mental health and substance use issues, and Indigenous women.