Smoking during pregnancy remains a significant public health concern worldwide, including in Northern Greece. The practice is associated with a multitude of adverse outcomes for both mothers and their babies, including low birth weight, preterm birth, placental complications, and long-term developmental issues for the child. Despite well-documented risks and public health campaigns aimed at reducing maternal smoking rates, the prevalence of smoking during pregnancy remains high in certain regions, such as Northern Greece. Contributing factors include high overall smoking prevalence among women in Greece, cultural normalization of smoking, and limited access to smoking cessation resources tailored to pregnant women. Social determinants play a significant role in shaping smoking behaviors during pregnancy. Women from lower socioeconomic backgrounds, those with lower educational attainment, and those experiencing financial or psychological stress are more likely to smoke during pregnancy. Additionally, a lack of strong public health policies and enforcement related to smoking cessation contributes to the persistence of this behavior
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