Aim: Prior studies of smoking among Lebanese pregnant women have not reported on measures of addiction and quitting plans. We aimed to assess measures of cigarette addiction, quitting plans, and behaviors prior to and during pregnancy, and their correlates among current pregnant women in Lebanon.

Design: Pregnant women presenting for prenatal services were interviewed about knowledge, attitudes and practices of cigarette smoking, degree of dependence, and quitting plans and actions.

Setting: A stratified sample of 23 primary care centers all over Lebanon.

Participants: A total of 864 women.

Measurements: Addiction scores, plans for quitting/stay quit, composite scores of knowledge of smoking harm and attitudes towards smoking control.

Findings: Of the 192 (22% of the total sample) women who smoked cigarettes prior to pregnancy, 41 (21%) quit due to pregnancy while 151 (79%) continued. Persistent smokers had higher addiction scores and higher self-rated smoking frequency than successful quitters. Although a third of persistent smokers tried to quit prior to pregnancy, only 21% were contemplating to quit now, without clear plans in the majority. Women’s attitudes towards smoking control measures, and to a lesser extent knowledge of smoking harm, correlated with prior success, and current interest in quitting.

Conclusions: Cigarette smoking among Lebanese pregnant women remains alarmingly high. Few pregnant smokers plan to quit. There are important gaps in attitudes and knowledge towards smoking, which can be exploited to increase interest in quitting. That many women tried to quit previously, but failed, represents missed opportunities for prevention in this population.