Introduction
If the pregnant woman smokes, this would easily lead to premature birth, the slow growth of the fetus in the womb. And the more she smokes, the bigger the influence will be. However, if the smoking woman quits smoking during pregnancy, the premature birth and the birth of low birth weight infants would be greatly reduced. (Hammoud et al., 2005; Vardavas et al., 2010) Therefore, quitiing smoking not only enhances the health of the pregnant woman but helps the fetus a lot. Half of the smoking women intend to quit smoking during pregnancy, especially in the first trimester. As soon as they found themselves pregnant, they intended to quit smoking. This is because they expect the fetus to be healthy. They don’t want the fetus to be harmed by smoking. (Thompson, Parahoo, McCurry, ODoherty, & Doherty, 2004 ) However, about 60% of the Taiwanese pregnant women’s spouses have the habit of smoking. About 4-5% of the pregnant women have the habit of smoking. And nearly all of the smoking women’s spouses have the habit of smoking. Even though the women actively quit smoking during pregnancy, they will smell second-hand smoking at home. (Shih, Chen, Wen, Yang, & Shih, 2008) If the pregnant women does not smoke cigarttes herself but is exposed to the surroundings of seond-hand smoking, the fetus would be influenced. It would be smaller than gestation age (SGA), easily becoming a low birth weight infant. (Aagaard-Tillery, Porter, Lane, Varner, & Lacoursiere, 2008; Chen, Li, Lin, & Sung, 2002) The more the spouse smokes at home, the more the fetus will be influenced. The second-hand smoking of the spouse would damge the health of the pregnant woman and fetus, luring the woman already quit smoking to resume the practice of smoking cigarettes. The difficulties confronted by the pregnant women intending to quit smoking are surely associated with their spouses who have the habit of smoking. (Ma, Goins, Pbert, & Ockene, 2005; Schneider, Huy, Schutz, & Diehl, 2010) The strongest predictable factor for the pregnant woman already quit smoking resumes the practice of smoking after birth is that her spouse has the habit of smoking. (Severson, Andrews, Lichtenstein, Wall, & Zoref, 1995) Smoking people are not only addicted to nicotine but consider smoking a part of their daily life and a way of enjoying relaxation. For the pregant woman quitting smoking, the symptoms of withdrawal caused by quitting smoking such as unstable emotion, insomnia, and thirsty would be improved as the time of quitting smoking increases. So would the sympotoms of storng disgusting and vomiting during the early stage of pregnancy. (Thompson et al., 2004 ; Ziebland & Mathews, 1998) However, when the woman sees her spouse smoking or the cigarettes at home, this would undermine her determination of qitting smoking, being eager to resume the practice of smoking cigarettes. (Edward & Sims-Jones, 1998; Moffatt & Whip, 2004; Tod, 2003) For these senarios would lure the pregnant woman quitting smoking to trace the enjoyment and taste of smoking cigarettes, making her unable to resist the impulse of smoking. On the other hand, the pregnant woman able to quit smoking during pregnancy frequently senses her spouse’s words of encourgeemnt and supporting acts. She is not alone in facing the challenge of quitting smoking. (Koshy, Mackenzie, Tappin, & Bauld, 2010) Therefore, when the medical and nursing staff help the pregnant woman to quit smoking, they are advised to invite her spouse to support her, and teach her spouse how to support her. This will lead to a more significant rate of smoking-quitting than they merely help the pregnant woman to quit smoking. (McBride et al., 2004)

Therefore, once a pregnant quits smoking, she would like to change those senarios that lure her to reume the practice of smoking cigarettes, and she surely also expects her spouse to reduce smoking or quit smoking, or at least not to smoke beside her. Although the spouse with the habit of smoking expects the pregnant woman to quit smoking, he does not always support her with the real action of quitting smoking. (Thompson et al., 2004 ) Therefore, some pregnant women began to complain while their spouses smoked, telling them about the influence of second-hand smoking and limiting their amount of cigarette smoking. Futhermore, they controlled the time and space for their spouses‘ cigarette smoking in order to protect themselves and fetuses from smoking second-hand smoking. However, the smoking spouses probably gave an oral promise, but did not carry out the promise. And they can actually refused to make any change. (Bottorff et al., 2010) They did not change their behavior of smoking cigarettes for the women were pregnant. (Bailey, Hill, Hawkins, Catalano, & Abbott, 2008) For although they could sense the expectation of their wives and accepted some pressure, the fetus they thought were protected in the womb of their wives so second-hand smoking should not make any influence on the fetus. (Wakefield, Reid, Roberts, Mullins, & Gillies, 1998) When the second-hand smoking of the spouse became the focus of conflict for the couple, threatening their mutual relations, the pregnant woman more often than not faced great psychological pressure. (Bottorff et al., 2006) In the past the couple smoked cigarettes at home together, which represented their intimate sharing. However, after the woman got pregnant, it would become a startpoint of arguments that the spouse enjoyed smoking before the woman. And this would even make the woman worry that their relations would be undermined.

According to the above documents, it can be seen that after the pregnant woman quit smoking, her atttitude towards her spouse‘ smoking became different from that before she quit smoking. She not only had to face her spouse’s second-hand smoking, but face the change of relationships between her and her husband. In Taiwan, the population of smoking females has gradually increased, so the smoking quitting of the pregnant women becomes an important subject. Due to male superioty of the Oriental culture, in the relation of the couple, males seldom change their lifestyle or habits for their wives. According to investigations, few Taiwanese males would like to quit smoking for their wives‘ pregnancy. And nearly all spouses of smoking females smoke. Therefore, 80% of the women continued smoking during the period of their pregnancy. And two thirds of the pregnant women having quit smoking resumed the practice of smoking within one year after birth. (Shih et al., 2008) In Taiwan in recent years the government has been also devoted to pushing for the campaign of smoke quitting, and in 2004 it began promoting’families without smoking cigarettes.‘Although medical and nursing staff advise smoking pregnant women to quit smoking, they neglect the second-hand smoking the pregnant women have to face after quitting smoking. Medical and nursing staff can not know how the pregnant women face their spouses‘ second-hand smoking alone during the period when they quit smoking. For the pregnant women who have sucessfully quit smoking, how do they face their spouses‘ second-hand smoking? How do they refuse to smoke second-hand smoking? When their spouses did not accept their advice to quit smoking, how did they respond? How did they feel? Research related to these aspects is not much. By knowing the pressure and difficulties confronted by the pregnant women in facing second-hand smoking, while helping the pregnant women quit smoking, we can better know how to reduce pressure, how to offer the pregnant women adequate support and help, how to develop the communication with the spouse to make him quit smoking or reduce the amount of cigarette smoking in order to prevent the damage of cigarette smoking and the damage caused by the second-hand smoking of the spouse. At the same time, it can help develop strategies to influence the smoking habit of the spouse of the pregnant woman. In order to effectively develop the measures of how the pregnant women respond to second-hand smoking, we have to have a good understanding of the pregant women’s experieces. Therefore, the purpose of this qualitative research is to research how the pregnant women whose spouses have the habit of smoking refuse their spouses‘ second-hand smoking during the process when they quit smoking. And how can they get along with their spouses who have the habit of smoking cigarettes?

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