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
DOI: 10.1080/03630242.2023.2228929
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Loyal D(1), Sutter AL(2)(3), Auriacombe M(3)(4), Serre F(4), Rascle N(2).
Author information:
(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.