The Pregnant Smoker Stigma Scale – Self Stigma (P3S-SS): development and validation in pregnant smoking women in France
Women & Health. 2023-07-03; 63(7): 507-517
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Loyal D(1), Sutter AL(2)(3), Auriacombe M(3)(4), Serre F(4), Rascle N(2).
(1)CRPMS, Paris City University, Paris, France.
(2)Inserm U1219 Bordeaux Population Health, Bordeaux University, Bordeaux, France.
(3)Psychiatry Department, Charles Perrens Hôpital, Bordeaux, France.
(4)CNRS USR 3413, SANPSY, Bordeaux, France.
Pregnancy smoking self-stigma may be associated with mental health and smoking
cessation. This study aims to validate the Pregnant Smoker Stigma Scale –
Self-Stigma (P3S-SS) assessing perceived and internalized stigma. Between May
2021 and May 2022, French pregnant smokers recruited online (n = 143) took the
P3S-SS and other scales assessing depressive symptoms (EPDS), social inclusion
(SIS), dissimulation, dependence (CDS-5), cessation self-efficacy (SEQ), and
intention. The two versions of the scale include four dimensions: derogatory
cognitions (« People think/I feel I am selfish »), negative emotions and behaviors
(« People make me feel/smoking makes me feel guilty »), personal distress
(« People/I feel sorry for me/myself »), and information provision (« People tell
me/I think about the risks of smoking »). Confirmatory factor analyses and
multiple regressions have been computed. Model fit was good for perceived stigma
and internalized stigma (X2/df = 3.06, RMSEA = .124, AGFI = .982, SRMR = .068,
CFI = .986, NNFI = .985; X2/df = 3.31, RMSEA = .14, AGFI = .977, SRMR = .087,
CFI = .981, NNFI = .979). Controlling for dependence, cessation intention was
positively predicted by perceived and internalized personal distress and
negatively predicted by perceived negative emotions and behaviors (Adj
R2 = .143, F(8,115) = 3.567, p = .001). Controlling for dependence,
dissimulation was positively predicted by internalized negative cognitions and
perceived personal distress and negatively predicted by internalized personal
distress (Adj R2 = .19, F(9,98) = 3.785, p = .000). The P3S-SS opens up exciting
avenues for further research. Stigma does not motivate women to stop smoking but
increases distress and dissimulation.