Tobacco Use and Motivation to Quit Among Pregnant Women: An Institutional Observational Study from Western Rajasthan.

Background: Tobacco use during pregnancy remains an important public health issue, especially in regions where smokeless tobacco is prevalent. Evidence on tobacco use patterns and motivation to quit among pregnant women is limited. The objective of this study is to assess the prevalence and pattern of tobacco use, motivation to quit, and their association with socio-demographic and clinical factors, among pregnant women attending a tertiary care centre in Western Rajasthan. Methodology: A hospital-based cross-sectional study using convenience sampling was conducted among 487 pregnant women attending a tertiary care antenatal clinic. Nicotine dependence was assessed using the Fagerström Test for Nicotine Dependence, and readiness to change using the transtheoretical model. Non-parametric tests, multivariable binary logistic regression, and multinomial logistic regression were used for analysis. Results: Tobacco use prevalence was 11.5%. Tobacco use was significantly more common among women with lower education, rural residence, semi/unskilled occupations, grand multiparity, and unplanned pregnancies. Advancing gestational age was associated with a greater likelihood of abstinence. Among active users, nearly two-thirds were in the precontemplation or contemplation stage, indicating low readiness to quit. Motivation to quit was significantly associated with FTND scores (H = 31.25, p = 0.005). Conclusions: Tobacco use during pregnancy was relatively common, with higher education associated with lower use. Culturally appropriate awareness and cessation counselling during antenatal care may improve maternal and fetal outcomes.