What do you think Dr Google? An Assessment of Online Information Concerning Smoking in Pregnancy

Abstract

Introduction: Continuing to smoke during pregnancy remains a significant public health concern today. While health professionals offer advice and guidance, pregnant women increasingly look to other sources of information in making health decisions, particularly online information, which is often reached via search engines. This study aimed to assess this online information to see whether it met the varied needs of individuals. Methods: The first 50 webpages for “smoking in pregnancy” and “smoking while pregnant” from the search engines Google and Bing were recorded. Duplicates, dead-links, webpages with pay-walls, webpages intended for academia, webpages unrelated to tobacco smoking and video-only content were removed. The remaining webpages were assessed under the headings of accessibility for people with disabilities (using Google Lighthouse), readability (using the Simplified Measure of Gobbledygook and the National Adult Literacy Agency (NALA) design guidelines) and content (using the Credibility Indicator and noting relevant topics based on previously published reviews). Results: Eighty-nine webpages were assessed after initial screening. Only 13 webpages were scored as having good accessibility for people with disabilities. The mean grade level was nine, with only one webpage being at the recommended level of grade five for health literature. Only 26 webpages were fully compliant with the NALA design recommendations evaluated. The median Credibility Indicator score was three (out of a possible score of eight). In terms of the topics discussed, some were covered widely including low birthweight (75.3%) and preterm birth (75.3%), however, other topics including congenital anomalies (34.8%), later behavioural difficulties (25.8%) and later obesity (11.2%) received less coverage. Conclusion: Information reached via search engines for women considering quitting smoking in pregnancy was found to be poorly accessible for people with disabilities and difficult to read. With regards to the content itself, the credibility and topics covered require substantial improvement.