Article| Volume 17, ISSUE 5, P325-332, September 2007

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Case Studies of Power and Control Related to Tobacco Use During Pregnancy

Published:August 13, 2007DOI:


      The objective was to identify and describe elements of power and control evident in couple tobacco-related interaction patterns during pregnancy.


      Using a case study approach, elements of the Duluth Abuse Intervention Project Power and Control Wheel were used to examine women’s experiences of tobacco reduction during pregnancy and post partum. Three cases were selected from a larger qualitative sample, using a maximum variation sampling approach.


      Although no direct evidence of partner abuse or violence accompanying partner efforts to influence women’s smoking was described, most of the elements of power and control were present in the case study, and appeared to cause an emotional toll and a negative impact on women’s ability to freely express their views about their own tobacco use.


      Elements of power and control, however subtle, are potentially important and unrecognized dimensions of women’s tobacco reduction experiences. Additional care and attention should be taken in designing tobacco reduction interventions and policies directed at pregnant and post partum women and their partners to reduce the possibility that these interventions may contribute to the use of power and control.
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      Lorraine Greaves, PhD, DU, is Executive Director of the British Columbia Centre of Excellence for Women’s Health, located at BC Women’s Hospital in Vancouver, Canada and Clinical Professor, Health Care and Epidemiology at the University of British Columbia. Her work focuses on gender analyses and women’s health, with a focus on substance use, addictions and violence issues.


      Joan L. Bottorff, PhD, RN, FCAHS, is Dean and Professor in the Faculty of Health and Social Development at the University of British Columbia Okanagan. As Co-Director of the research unit NEXUS, her work focuses on the social context of health behavior.


      Cecilia Kalaw, MA, was a researcher with the Nursing and Health Behaviour Research Unit and Project Director for the study, Patterns of family interaction influencing tobacco reduction during pregnancy and postpartum. She currently works as a research facilitator for the Faculty of Health Sciences, Simon Fraser University in Burnaby, BC, Canada.