Background: The issue of active and passive cigarette smoking among pregnant women at home has become a major source of debate. The purpose of this study was to explore the knowledge of, self-efficacy with, and behavior toward avoiding environmental tobacco smoke and related factors among pregnant women in Taiwan. Methods: A cross-sectional research design was used. Women (n = 281) visiting the outpatient antenatal clinics of one regional hospital and two medical centers in Taipei for routine obstetrical care volunteered to fill out questionnaires. Results: Participants on average had little knowledge of this issue and felt less than "very confident" in resisting environmental tobacco smoke and indicated that it was only "usually true" that they practiced avoidance behaviors. The knowledge of, self-efficacy with, and behavior toward avoiding environmental tobacco smoke were all related to both the woman and her partner's educational levels. There were significant differences in mean knowledge, self-efficacy, and avoidance of environmental tobacco smoke scores among different household smoking groups. A multiple regression revealed that overall avoidance of environmental tobacco smoke was positively associated with self-efficacy, with a no-smoking policy at home, and with both a woman and her partner's educational levels. Conclusions: The high prevalence of subjects suffering from active (6.05%) and passive smoking (58.72%) suggests that clinicians can target interventions designed to increase pregnant women's self-efficacy and to advise them to try to set up their own smoking policy at home.
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