Introduction:
Smoking during pregnancy is a factor which increase health risks to the fetus and causes numerous health problems to the mother. Many women know the risks associated with smoking but find it difficult to quit smoking; smoking relapse after birth is common among those who quit before or during pregnancy. The aim of this study is to explore risk factors for postnatal smoking relapse in a sample of Romanian women.

Methods:
Based on a pre-set interview guide, we conducted twelve semi-structured face-to-face interviews (Oct-Dec 2017) in two Obstetrics-Gynecology Clinics in Cluj-Napoca, with 12 women who recently gave birth and quit smoking before pregnancy or during pregnancy. The interviews were audio recorded and transcribed. Data were coded separately by two coders and the final coding system was developed through a consensus process.

Results:
The average age of the women we interviewed was 30 years and the average age when they start smoking was 18 years. Three themes emerged from the analysis: (1) most women cited “stress”, “future baby’s health problems”, “the other smokers”, “smoker partner” as the main risk factors for relapse, (2) many women (7/12) said they relapsed smoking in the first days after birth because of the stress accumulated during their stay in the clinic, and (3) factors like “weight loss” were present too when the women tought about relapse.

Conclusions:
Common risk factors for smoking relapse after pregnancy include: stress, possible baby’s health problems, a smoker partner and factors that have to do with body image, like weight loss. New mothers need support after the birth. The postpartum smoking relapse is a complex issue, and understanding risk factors at multiple levels (e.g. personal, social and cultural background) may represent the best approach for prevention.

Funding:
This work was supported by a grant of Ministry of Research and Innovation, CNCS - UEFISCDI, project number PN-III-P4-ID-PCE-2016-0632, within PNCDI III.