Nicotine was not included in previous efforts to identify the most important toxicants of tobacco smoke. A health risk assessment of nicotine for smokers of cigarettes was conducted using the margin of exposure (MOE) approach and results were compared to literature MOEs of various other tobacco toxicants. The MOE is defined as ratio between toxicological threshold (benchmark dose) and estimated human intake. Dose-response modelling of human and animal data was used to derive the benchmark dose. The MOE was calculated using probabilistic Monte Carlo simulations for daily cigarette smokers. Benchmark dose values ranged from 0.004 mg/kg bodyweight for symptoms of intoxication in children to 3 mg/kg bodyweight for mortality in animals; MOEs ranged from below 1 up to 7.6 indicating a considerable consumer risk. The dimension of the MOEs is similar to those of other tobacco toxicants with high concerns relating to adverse health effects such as acrolein or formaldehyde. Owing to the lack of toxicological data in particular relating to cancer, long term animal testing studies for nicotine are urgently necessary. There is immediate need of action concerning the risk of nicotine also with regard to electronic cigarettes and smokeless tobacco.

Master of Science / Department of Journalism and Mass Communications / Nancy Muturi / Cigarette smoking is one of the leading causes of preventable deaths in the U.S. and a global public health concern. The health effects have been severe among the youth. Smoking among the youth has been attributed to media. Movie in particular, is perhaps the most successful advertising on cigarette. Research shows that greater exposure to smoking in movies predicts increased likelihood of trying smoking. The purpose of this experimental study was to explore the relationships of smoking exposure in movies and young adults’ attitude, intention, and risk perception toward smoking. The theory of reasoned action (TRA) and the Attitude Accessibility Concept served were used in the study. The experiment was conducted at 70 Kansas State University students and examined the extent to which young adults’ memory/experience on smoking are triggered by watching smoking scenes; and whether young adults had different reactions based on the level of dosages of onscreen smoking. The results showed that the relationship of onscreen smoking and young adults’ memory/experience on smoking is not significant, as well as the relationship of media exposure and young adults’ attitude to smoke. However, the study found that nonsmokers contain considerable anti-smoking attitude and significant risk perception to smoke. The anti-smoking attitude is highly associated with the risk perception. The study presented theoretical implications, which includes the proposal to incorporate risk perception in the model of TRA, made recommendations to future anti-smoking campaigns targeted on young adults, and suggested areas of further research.

This study examined factors that may protect African-American young adults in college from early onset of cigarette smoking, and factors that may place them at risk for cigarette smoking, using the framework of the Social Cognitive Theory. It was hypothesized that existing regulation of smoking, positive attitude toward academics and school connectedness would be related to low cigarette-smoking rates, while exposure to pro-tobacco promotions would be related to high cigarette smoking rates. A convenience sample of 576 undergraduates at Dillard University of New Orleans completed a Harvard College Alcohol Study survey. Forty six percent (n=269) completed the survey. Ninetyone percent were African American, and 13% of them were ever-smokers. Chi Square analysis was used to test for a statistically significant difference in response rates between eversmokers and non-smokers. Results indicated no significant differences between respondents for any outcome measures. The Social Cognitive Theory constructs were not supported by the findings.The results of this study do not support any of the hypotheses. The Social Cognitive Theory constructs used to examine the hypotheses are not supported by the findings. Future studies should address the limitations of this research by using a random sampling technique, sampling across all academic classification levels, and assessing the validity and reliability of the Harvard College Alcohol Study survey measures for cigarette smoking.

Background: Smoking is the cause of the deaths of up to 7,000,000 people worldwide and can be referred to as a global pandemic. There are 25% of the adult population smoke in the Czech Republic and it is estimated that there are currently 2.4 million active daily smokers. Cardiovascular disease (CVD) is the most common cause of death in the Czech Republic and approximately 50,000 people die every year. In all these deaths, smoking accounts for 26% of men and 12% of women. According to available studies, smoking is directly related to CVD and is a major risk factor for this disease. Both of them, tobacco use and chronic CVD are thought to have a significant impact on the deterioration in quality of life. Aims : The main goal of the diploma thesis was to assess the subjective perception of the quality of life of smokers in connection with the decision to quit smoking in the acute phase of cardiovascular disease and with a three- month interval to find possible connections between tobacco use and quality of life. Methods: The research was based on a quantitative approach, in the form of a questionnaire survey. A set of 34 respondents was selected according to predetermined criteria. These were patients III. Department of Internal Medicine - Cardiology Clinic, University Hospital Královské Vinohrady,...

O tabagismo mata um a cada 10 fumantes no mundo e é a principal causa evitável de morbimortalidade. O Brasil possui cerca de 25 milhões de tabagistas. Os profissionais de Saúde têm um importante papel no controle da pandemia do tabagismo, seja como educadores, formadores de opinião ou como promotores de prevenção e tratamento. A epidemia de tabagismo nas últimas décadas caracteriza-se pela redução do número de usuários de cigarro e crescente uso de formas alternativas de tabaco. Este estudo teve como objetivo caracterizar o perfil de consumo, crenças, percepção de risco, atitudes e conhecimentos a respeito de tabagismo em estudantes de Medicina do 1º e 6º anos. Trata-se de um estudo observacional transversal, com componente descritivo e com componente analítico. Foram entrevistados alunos do curso de Medicina de uma faculdade pública (FMRP-USP) e de três faculdades privadas (UniSEB, UNAERP e Centro Universitário Barão de Mauá) da cidade de Ribeirão Preto-SP. O questionário incluiu dados sócio demográficos, de exposição ao tabaco e outras substâncias psicoativas, motivação para cessação, avaliação de conhecimento médico sobre tabagismo, atitudes perante o tabaco e percepção de risco. A coleta de dados aconteceu nos anos de 2016 e 2017. A análise de dados foi realizada com o auxílio do programa estatístico Statistical Package for the Social Sciences (SPSS). Adotou-se como nível de significância para todas as análises p <= 0,05. 859 alunos foram convidados a participar da pesquisa e 420 responderam o questionário, 63,3% era do sexo feminino. Os achados do presente estudo vão ao encontro com o que vem sendo descrito na literatura. A prevalência de tabagismo encontrada foi semelhante à prevalência de tabagismo no Brasil, porém uma prevalência menor em alunos do 1º ano. A idade média de experimentação foi de 17,5 anos. A maioria dos estudantes não se via como dependente de tabaco, fazia uso ocasional e utilizava principalmente o Narguilé (15,2%), produto considerado mais prejudicial quando comparado ao cigarro comum (p>0,001). O consumo de álcool foi elevado e descrito como um facilitador para o uso de tabaco. A nicotina foi considerada viciante (p>0,001). O fumo ocasional foi considerado prejudicial (88,3%), assim como o uso dos diferentes produtos de tabaco na gestação. No que diz respeito ao papel dos profissionais de saúde, 93,1% acredita que deveria aconselhar seus pacientes a parar de fumar; 63,7% que profissionais fumantes seriam menos propensos a aconselhar seus pacientes; 81,3% acredita que deveria aconselhar seus pacientes a evitar outras formas de tabaco e 78,2% considera esses profissionais modelo para pacientes e público em geral. Verificou-se a falta de conhecimento e percepção de risco distorcida (crenças) quanto ao potencial de dependência dos produtos alternativos de tabaco e riscos do tabagismo. Sextanistas relataram ter recebido treinamento formal para abordagem do fumante e cessação do tabagismo e sentir-se seguros para orientar seus pacientes. Formação e treinamento adequados são essenciais e demandam maior responsabilidade social e acadêmica pelos estudantes de Medicina. Investir em ações que trabalhem especialmente as crenças, percepções de risco e atitudes a respeito dos diferentes tipos de tabaco, são necessárias para uma maior conscientização quanto ao uso e prejuízos à saúde causados pelo tabagismo. / Smoking kills one out of every 10 smokers in the world and is the leading preventable cause of morbidity and mortality. Brazil has about 25 million smokers. Health professionals play an important role in the control of the tobacco pandemic, whether as educators, opinion makers, or as promoters of prevention and treatment. The smoking epidemic in recent decades is characterized by reduction in the number of cigarette users and increasing use of alternative forms of tobacco. This study aimed to characterize the profile of consumption, beliefs, perception of risk, attitudes, and knowledge about smoking in medical students of 1st and 6th years. This is an observational cross-sectional study, with descriptive and analytical component. Medical students of a public college (FMRP-USP) and of three private colleges (UniSEB, UNAERP and Centro Universitário Barão de Mauá) of the city of Ribeirão Preto-SP were interviewed. The questionnaire included socio-demographic data, exposure to tobacco and other psychoactive substances, motivation for cessation, assessment of medical knowledge about tobacco use, attitudes, and perception of risk. Data collection occurred in 2016 and 2017. Data analysis was performed with the aid of the statistical program Statistical Package for the Social Sciences (SPSS). The significance level adopted for all analyses was p <= 0.05. Among 859 students invited, 420 answered the questionnaire, 63.3% female. The findings of this study respond to what has been described in the literature. The smoking prevalence found was similar to Brazil\'s average, but lowest in first-year students. The average age of experimentation was 17.5 years. Most students did not identify themselves as tobacco addicts, were occasional users and used mainly hookahs (83%), product considered more harmful when compared to cigarettes (p > 0.001). Alcohol consumption was high, described as a facilitator for the use of tobacco; nicotine is regarded as addictive (p > 0.001); casual smoke as harmful (88.3%), as well as the use of different tobacco products in pregnancy. With regard to the role of health professionals, 93.1% believe they should advise their patients to quit smoking; 63.7% believe that professionals who are smokers would be less likely to advise their patients; 81.3% believe they should advise their patients to avoid other forms of tobacco, and 78.2% consider these professionals an example for patients and the general public. A lack of knowledge and distorted perception of risk (beliefs) was noted about the addictiveness of alternative products of tobacco and risks of smoking. Sixth-year students reported having received formal training to approach the smoker and cessation of smoking and feel safe to guide their patients. Appropriate education and training are essential and require greater academic and social responsibility by medical students. Investing in actions that work especially on beliefs, perception of risk and attitudes regarding the different types of tobacco are necessary for a greater awareness regarding the use and damage to health caused by smoking.

Waterpipe smoking (WPS) is a global epidemic. The prevalence of WPS threatens to surpass cigarette smoking in certain parts of the world. Although current WPS interventions have had some effect in creating awareness of the dangers of WPS, these interventions alone have not succeeded in reducing WPS among university students, despite them knowing the harmful effects of WPS. Since WPS is seen to be a social event, a more holistic perspective of reducing WPS through linking health psychology with social factors encountered such as emphasizing the influences of the collective group and social connections on individual smoking behavior. Thus, social capital is a useful concept, which focuses our attention on an important set of resources inherent in relationships, networks, associations and their norms; all of which have been given insufficient priority in the health literature. The aim of this research was to examine what cognitive and structural bonding social capital factors contributed towards the understanding of WPS behaviors. Thus, this study explored three questions: How has exposure to previous WPS campaigns and/ or interventions influenced participants behavior towards WPS? What was the association between structural factors of WPS and bonding social capital among university students in relation to WPS? What was the association between cognitive factors of WPS and bonding social capital among university students in relation to WPS? A qualitative evaluation using three focus group interviews were used to answer the questions. The study design followed an abductive approach. The data was analyzed using thematic content analysis. Results from the study suggested that even though there have been numerous health interventions to reduce WPS, such as education in schools, posters at the university and TV documentaries, people continue to smoke the waterpipe, despite knowledge of the dangers of WPS smoking. Instead, participants attributed their frequent smoking behavior to groups collectively influencing each other to smoke. Factors of hygiene, homogenous group composition (in terms of race, age and/ or education) and the type of organizational setting (familiar vs. unfamiliar), played a role in the way social relations and interactions influence permeability and mobility of WPS groups, reinforcing structural bonding social capital. Factors of cognitive bonding social capital were also highlighted, where prior contact and gender played a role in setting out conditions of exclusion. Cognitive bonding social capital, along with the structural aspects, is a useful way to understand how these connections may be linked to population health, especially in WPS. Thus, health promoters need to invest more energy into developing programs and policies that take into consideration the social dimensions within the broader context of the university, which social capital may have to offer, contributing to a more critical approach to health psychology when designing interventions and cessation programs.

Introduction: The deleterious health effects of tobacco use and smoking in particular have been well documented. Anti-smoking campaigns have been in existence for decades. Doctors, generally perceived as role models by members of their societies, can play a significant role in anti-tobacco programmes. Objectives: The objectives were: to determine the prevalence of tobacco use among medical students, their knowledge of the health effects of tobacco use, their beliefs and perceptions about anti-tobacco legislation/restrictions and the role of doctors as advocates in tobacco-cessation programmes. Methodology: A cross-sectional census was carried out using the 3rd and 5th year students at the medical school of the University of the Witwatersrand (n = 357). Results: The total prevalence of smoking was 15.4% (n = 53), with 9.6% (n = 34) smoking occasionally and 6.2% (n = 22) smoking daily. Among the smokers, more of the 3rd year students smoked daily compared to the 5th years (64% vs 19.3%, p = 0.001). Overall, there were no major differences between the sexes with respect to prevalence of smoking (P= 0.312 Fischer exact test) across both classes. Within the male population (Africans, whites and Asians) overall differences ( 2- אל 11.1, p= 0.006) existed in their smoking patterns. Both the whites and the Asians smoked more than their African counterparts (5.8%, n = 3). There were however no differences in the smoking prevalence rates between the whites and the Asians ((20.9% vs 31.6%: p= 0.314). The females differed (P = 0.042 Fischer exact test) in their smoking behaviour across the races: Coloured (33.3%, n = 2), white (16.5%, n = 18), Asian (13.3%, n =9) and Africans (4.0%, n = 2). The prevalence of noncigarette tobacco use was 14%, with the majority smoking hookahs (7.1%, n=26). More of the 5th year students than their 3rd year students counterparts (23.5% vs 7.1%) had very good knowledge of tobacco cessation techniques and overall differences were observed ( 2אל -35.5, P <0.001). About 90% (n = 316) of the students knew about the dangers of smoking, but 12% (n = 41) did not associate smoking with heart disease. About 45% (n= 179) of the respondents believed that ban of smoking in public space had reduced prevalence rates and about 40% (n= 172) believed that taxation had reduced prevalence rates of tobacco use in South Africa. Almost 50% (n= 164) students believed that the ban of tobacco sales to minors had reduced prevalence rates and about 85% (n= 286) of the respondents agreed that pictorial health warnings should be placed on the packages of tobacco products. The students generally believed that doctors are seen as role models (84%, n= 286) by society and should not smoke (86.3%, n= 299). Even though 81% (n= 279) of the students were willing to speak to the community about the dangers of tobacco, only about 30% (n= 101) were willing to be members in an anti-tobacco organisation. Discussion and conclusion: The prevalence of smoking among the respondents was lower than national prevalence rates among adults but similar to that of South African young adults. The students had a low knowledge of tobacco cessation techniques. Less than half of the respondents believed that the current anti-tobacco legislation was effective and the majority supported the inclusion of pictorial warnings on the packages of tobacco products. The majority of the participants agreed that doctors were perceived as role models by members of their communities and should not smoke. There was a general willingness on the part of the respondents to advice their patients to quit smoking but majority of the participants however would not want to get involved in anti-tobacco organisations in the future.

Orientador: Marli Teresinha Cassamassimo Duarte / Resumo: Justificativa: Apesar de todos os esforços no combate ao tabagismo, em diversos países a prevalência de tabagistas na população com HIV/aids é elevada, aumentando a taxa de mortalidade nestes indivíduos, pois estes estão mais suscetíveis aos perigos do tabaco do que as pessoas não infectadas. O consumo do cigarro pode estar associado a diversos fatores como: baixo nível socioeconômico e de escolaridade, uso de drogas ilícitas e álcool, sintomas de depressão e falta de acesso aos serviços de saúde. O tabagismo é fator de risco que pode ser modificado e evitado. No Brasil há escassez de estudos de prevalência nas pessoas que vivem com HIV/aids, mas a hipótese é que este número também seja elevado. Objetivos: Analisar a prevalência do tabagismo em pessoas infectadas pelo HIV/aids; avaliar o grau de dependência da nicotina; avaliar o estágio de motivação relacionado à cessação de fumantes; analisar fatores associados ao tabagismo; compreender as representações sociais do tabaco em pessoas que vivem com HIV/aids tabagistas. Metodologia: O estudo foi realizado em duas etapas. A etapa I tratou-se de estudo exploratório e transversal e a II de estudo qualitativo. Foi desenvolvido no Serviço de Ambulatórios Especializados de Infectologia “Domingos Alves Meira”, que atende uma região de 30 municípios, com pacientes infectados pelo HIV/aids. Os dados foram obtidos por meio da aplicação de formulários a uma amostra calculada de 200 pacientes e participaram da etapa II do estudo 38 pacien... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Justification: Despite all efforts in the fight against smoking, in several countries the prevalence of smokers in the population with HIV / AIDS is high, increasing the mortality rate in these individuals since they are more susceptible to tobacco dangers than non-smokers. infected. Cigarette smoking may be associated with several factors such as low socioeconomic status and schooling, use of illicit drugs and alcohol, symptoms of depression and lack of access to health services. Smoking is a risk factor that can be modified and avoided. In Brazil, there is a shortage of prevalence studies among people living with HIV / AIDS, but the hypothesis is that this number is also high. Objectives: To analyze the prevalence of smoking among people infected with HIV / AIDS; evaluate the nicotine dependence degree; evaluate the stage of motivation related to smoking cessation; analyze associated smoking factors; understand the social representations about tobacco among smokers with HIV / AIDS. Methodology: The study was carried out in two stages. Stage I was an exploratory and cross-sectional study, and the second was a qualitative study. It was developed in the Specialized Outpatient Clinic of Infectious Disease "Domingos Alves Meira", wich serves a region of 30 counties with patients infected by HIV / AIDS. The data were obtained through the application of forms to a calculated sample of 200 patients and participated in stage II of the study 38 smokers, whose sample was obtained by s... (Complete abstract click electronic access below) / Doutor

Introdução: O câncer de pulmão é associado a campanhas antitabaco que, se por um lado ajudaram a reduzir a incidência de fumo e câncer de pulmão, por outro contribuíram para a culpabilização e estigmatização do doente em relação à sua doença, além associá-la fortemente a morte e sofrimento. Estigma é um rótulo socialmente negativo imposto a um indivíduo que acarreta sofrimento a quem o recebe. Existem poucos instrumentos que mensuram o estigma associado ao câncer de pulmão e nenhum deles foi validado no Brasil. Objetivo: Adaptar e validar para a língua portuguesa brasileira a Cataldo Lung Cancer Stigma Scale (CLCSS) em pacientes com câncer de pulmão. Método: Trata-se de um estudo metodológico desenvolvido com 188 pacientes em tratamento ambulatorial por câncer de pulmão. Os dados foram coletados nos anos de 2014 e 2015 em dois serviços privados de oncologia na cidade de São Paulo. Os pacientes foram caracterizados nos aspectos sociodemográficos e clínicos. Para testar as validades convergentes e divergentes verificou-se a associação entre estigma e ansiedade, estigma e depressão e estigma e autoestima. A validade do construto foi avaliada por meio da análise fatorial exploratória. A consistência interna e o teste-reteste (37 pacientes) foram utilizados para análise da confiabilidade. Os dados foram analisados por meio do programa estatístico SPSS® v. 22.0. Resultados: A maioria dos pacientes era composta por homens (55,3%), brancos (86,7%), viviam com companheiros (72,9%), tinham nível de escolaridade superior (43,6%), idade média de 63 anos e renda familiar média de R$13.747,90. O tipo de câncer de pulmão prevalente foi o de células não pequenas (94,1%), o estágio foi o avançado (82,5%) e a média de tempo do diagnóstico foi de 22,9 meses. Tinham história prévia de uso do tabaco 68,6% dos pacientes. Os pacientes apresentaram baixos escores de ansiedade e depressão, a autopercepção de ser estigmatizado quase não foi observada e demonstraram altos escores de autoestima. A CLCSS versão brasileira foi validada com 24 itens e a análise fatorial exploratória confirmou os quatro fatores da escala original. Os coeficientes alfa de Cronbach variaram entre 0,63-0,89 para as subescalas (0,77 para estigma e vergonha, 0,88 para isolamento social, 0,89 para discriminação e 0,63 para tabagismo) e o alfa total foi de 0,85. Houve fraca correlação positiva entre estigma e depressão (r=0,25; p=0,000) e estigma e ansiedade (r=0,30; p=0,000) e fraca correlação negativa entre estigma e autoestima (r=-0,44; p= 0,000). A CLCSS apresentou-se estável nas duas avaliações (CCI= 0,7). Conclusões: Os testes psicométricos apontaram a validade e a confiabilidade da CLCSS-versão brasileira. Novas pesquisas devem ser realizadas em amostras com características diversas. / Introduction: Lung cancer is associated with tobacco campaigns, that helped to reduce the incidence of smoking and lung cancer but, on the other hand, contributed to the blame and stigmatization of the patient about the disease, as well as strongly associate it with death and suffering. Stigma is a socially negative label imposed on a person who causes suffering to the recipient. There are few instruments that measure the stigma associated with lung cancer and none have been validated in Brazil. Objective: To validate a Brazilian Portuguese language Cataldo Lung Cancer Stigma Scale (CLCSS) in patients with lung cancer. Methods: This is a methodological study conducted with 188 patients receiving outpatient treatment for lung cancer. Data were collected in 2014 and 2015 in two private oncology services in the city of São Paulo. Patients were characterized in sociodemographic and clinical aspects. To test the convergent and divergent validity it has been found the association between stigma and anxiety, stigma and depression and stigma and self-esteem. The construct validity was evaluated by exploratory factor analysis. Internal consistency and test-retest (37 patients) were used to analyze the reliability. Data were analyzed through the statistical program SPSS v. 22.0. Results: Most patients were men (55.3%), white (86.7%), living with partners (72.9%), had higher level of education (43.6%), mean age 63 years and average household income of R$ 13,747.90. The prevalent type of lung cancer is the non-small cell (94.1%), the stage was advanced (82.5%) and the mean time from diagnosis was 22.9 months. 68.6% of patients had a history of tobacco use. The patients had low scores of anxiety and depression, self-perception of being stigmatized almost was not observed and demonstrated high scores of self-esteem. The CLCSS - Brazilian version was validated with 24 items and exploratory factor analysis confirmed the four factors of the original scale. The Cronbach alpha coefficients ranged from 0.63 to 0.89 for the subscales (0.77 to stigma and shame, 0.88 for social isolation, discrimination and 0.89 to 0.63 for smoking) and the total alpha was 0.85. There was a weak positive correlation between stigma and depression (r=0.25; p=0.000) and stigma and anxiety (r=0.30; p=0.000) and a weak negative correlation between stigma and self-esteem (r=-0.44; p=0.000). The CLCSS remained stable in both assessments (ICC=0.7). Conclusions: The psychometric tests showed the validity and reliability of the Brazilian CLCSS-version. Further studies should be performed on samples with different characteristics

Introdução: O consumo do tabaco é a principal causa mundial de mortes preveníveis, com estimativa de seis milhões de mortes por ano atribuíveis ao fumo. Configurando-se, então, como uma problemática de proporção mundial que compromete não apenas a qualidade de vida das pessoas, mas influencia índices e perfis de morbimortalidade em diversas regiões do mundo. Da mesma forma que o tabagismo não afeta de maneira homogênea países com desenvolvimento econômico distintos, seus efeitos são mais perceptíveis em países pobres e em desenvolvimento; numa população são as pessoas de classes sociais menos favorecidas que mais consomem o tabaco. Nesse sentido, as mulheres têm um perfil vulnerável para o consumo do tabaco e especificamente a gestação, configura-se como um momento propício para o abandono do tabagismo. Os fatores que levam as gestantes a fumar durante a gestação estão fortemente associados as suas condições socioeconômicas. Objetivo: conhecer a rede social da gestante tabagista acompanhada na Atenção Básica e sua interferência em seu estado de saúde. Método: trata-se de um estudo exploratório-descritivo de abordagem qualitativa, que utilizou a entrevista para construção do genograma e ecomapa das participantes. Participaram do estudo 10 gestantes tabagistas acompanhadas nas Unidades Básicas de Saúde do bairro de Cidade Tiradentes, na região Leste da cidade de São Paulo. Resultados: o estudo evidenciou que as famílias estão estruturadas sob uma rede de cuidado que envolve várias gerações. Apesar de a família nuclear estar presente, a integração da rede de parentesco é fundamental na condução das atividades rotineiras. As características socioeconômicas demonstram baixa escolaridade das gestantes, precária inserção no mercado de trabalho, dependência econômica de outros membros da família e baixa renda familiar. Em relação ao tabagismo, o meio social apresentou-se permeado pelo consumo do tabaco, perpassando gerações e sendo encarado com naturalidade nas normas familiares. As instituições que fazem parte da vida familiar são a creche, a UBS, o trabalho, a vizinhança e a família ampliada. O lazer raramente foi citado e quando presente estava restrito ao ambiente doméstico. Em relação à abordagem do tabagismo no acompanhamento pré-natal, constatou-se a inexistência de uma intervenção coordenada e longitudinal e esta, quando presente, mostrou-se fragmentada e pontual. Diante da análise temática das falas das gestantes, foi possível apreender elementos que podem ser facilitadores ou dificultadores para a cessação do tabagismo. Conclusão: dificuldades de lidar com o estresse e questões relacionadas à dinâmica familiar demonstram que o tabagismo precisa ser encarado como uma escolha individual fortemente influenciada por um contexto social. Compreender a rede social e reciprocidade no apoio é fundamental para abordar a questão do tabagismo numa perspectiva social do cuidado / Due to the magnitud of tobacco problem for public health, and, specifically, due to the damage for the mother and her baby, this study aimed at knowing the social network of smoking pregnant women followed in primary care and its interference in her health. This was an exploratory-descriptive study with a qualitative approach that used interviews to build the genogram and eco-map of the participants. The data were analyzed using thematic analysis and discussed by means of a theoretical framework for health promotion. Ten pregnant smokers, followed in primary care in Cidade Tiradentes neighborhood, in the east of the city of São Paulo participated in the study. The study showed that the families are structured in a transgenerational care network. Although the nuclear family is present, the integration of a kinship network is necessary to conduct routine activities. In terms of socioeconomic characteristics, the participants showed low educational level, poor integration into the labor market, economic dependence on other family members and low income. Regarding smoking, the social environment is permeated by tobacco consumption, which spreads through generations and is seen as common in family rules. The institutions that are part of family life are the day care center, public health center, work place, neighborhood and the extended family. The bonds are poor and based on relationships involving favors and/or cooperation. Leisure was rarely mentioned and when present, it was restricted to the domestic environment. Regarding smoking treatment in prenatal care, there was a lack of coordinated and longitudinal intervention, which was fragmented and occasional. The thematic analysis of the participants discourse revealed elements that can be facilitators or obstacles to smoking cessation. These elements suggest the relevance of smoking to the pregnant women and help direct the intervention to a more effective approach. Difficulties in dealing with stress and issues related to the family dynamics show that smoking must be seen as an individual choice strongly influenced by the social context. Understanding the social network and the importance of reciprocal support is critical to address the issue of smoking in a social perspective of care