Post-partum intention to resume smoking

Röske, K.; Hannöver, Wolfgang; Grempler, Julia; Thyrian, Jochen René; Rumpf, Hans‐Jürgen; John, Ulrich; Hapke, Ulfert

doi:10.1093/her/cyh069

Cited by 30 publications

(22 citation statements)

References 20 publications

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“…Elevated stress during the post-partum period (26), living with a smoker (25), and intention to resume smoking (34) have all been identified as predictors of post-partum smoking relapse. Our results also support previous findings regarding key factors that contribute to postpartum smoking abstinence, including breastfeeding (35), social support (36), confidence in staying quit (37), and using effective coping strategies (17).…”

Section: Discussionmentioning

confidence: 99%

A Content Analysis of Attributions for Resuming Smoking or Maintaining Abstinence in the Post-partum Period

Correa

Simmons

Sutton

et al. 2014

Matern Child Health J

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Objectives A significant proportion of women who self-quit smoking during pregnancy subsequently relapse to smoking post-partum. This study examined free-text responses describing attributions of smoking relapse or maintained abstinence at 1, 8, and 12 months post-partum. Method This study reports secondary analyses from a randomized clinical trial (N = 504) for preventing post-partum smoking relapse. At each follow-up, one survey item asked the participant to describe why she resumed smoking or what helped her maintain abstinence. A thematic content analysis was conducted on responses from the 472 participants (94.0 % of the original sample) who returned at least 1 survey. Results Content analyses revealed several themes for participants’ reasons for relapse and abstinence. Stress was the most frequently cited reason for smoking relapse across all follow-ups. Health concerns for children and family was the most common reason provided for remaining abstinent. Chi-square analyses revealed differences in written responses related to income, age, and depressive symptoms. Conclusions Overall, these findings suggest that during the post-partum period, stress and familial health concerns are perceived contributors to smoking relapse and abstinence, respectively. These results confirmed key risk and protective factors that have been identified through other assessment modalities (e.g., quantitative surveys and focus groups). They also provide support for targeting these variables in the development, content, and delivery of future post-partum smoking relapse-prevention interventions. The high response rate to these open-ended attribution questions suggests that future studies would benefit from including these and similar items, to allow for additional insight into participant perspectives.

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Section: Discussionmentioning

confidence: 99%

A Content Analysis of Attributions for Resuming Smoking or Maintaining Abstinence in the Post-partum Period

Correa

Simmons

Sutton

et al. 2014

Matern Child Health J

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“…First, compared to others who quit smoking, pregnant women are more likely to be motivated by extrinsic factors (e.g., health of fetus, social pressure, nausea) to suspend their smoking during their pregnancy, rather than attempting to quit permanently (Curry et al, 2001, Roske et al, 2006Stotts et al, 2000). Women who intend to resume smoking after giving birth presumably are less likely to seek help for maintaining their tobacco abstinence (although one-third of our reactive sample reported that they did not plan to "quit for good").…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, the motivation to remain abstinent differs among general population quitters and pregnant ex-smokers (Stotts et al, 1996(Stotts et al, , 2000. Clinical experience indicates that smokers in general tend to quit with the goal of continued abstinence, yet many pregnant women who quit smoking are motivated primarily by concerns about the health of the fetus, and therefore plan to abstain only during their pregnancy (Curry et al, 2001;Roske et al, 2006). Women also face unique stressors after they give birth, such as: identity confusion during the transition between pregnancy and postpartum, the reintroduction of smoking cues (e.g., spousal smoking) that were avoided during pregnancy, and the increased stress of caring for a new baby (Quinn et al, 2006).…”

Section: Overview Of Clinical Trialmentioning

confidence: 99%

Clinical trials and tribulations: Lessons learned from recruiting pregnant ex-smokers for relapse prevention

Lopez

Simmons

Quinn

et al. 2008

CNTR

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The development of smoking cessation and relapse-prevention interventions for pregnant and postpartum women is a public health priority. However, researchers have consistently reported substantial difficulty in accruing this population into clinical trials. The problem is particularly acute for relapse-prevention studies, which must recruit women who have already quit smoking because of their pregnancy. Although an important target for tobacco control efforts, these individuals represent an extremely small subgroup of the general population. This paper describes multiple recruitment strategies utilized for a clinical trial of a self-help relapse-prevention program for pregnant women. The effectiveness of the strategies and the direct expense per participant accrued are provided. A proactive recruitment strategy (telephoning women whose phone numbers were purchased from a marketing firm) was ultimately much more successful than a variety of reactive strategies (advertisement, press releases, direct mail, web placement, healthcare provider outreach). There were few differences between proactively and reactively recruited participants on baseline variables; the primary difference was that the former had smoked fewer cigarettes per day and reported lower nicotine dependence prior to quitting. Strengths and limitations of the recruitment strategies are discussed.The risks associated with smoking during pregnancy are well established and highly publicized (Britton, 1998; CDC, 1995; United States Department of Health and Human Services [USDHHS], 1990[USDHHS], , 2001. Consequently, an increasing proportion of women (estimates range from 15% to 60%) spontaneously quit smoking immediately prior to or during their pregnancy (Ershoff et al., 2000;Morasco et al., 2006). However, maintenance of tobacco abstinence among pregnant and postpartum women remains a challenge. Smoking relapse rates among pregnant and postpartum women range from 70-80%, with approximately half of these women resuming smoking within the first twelve weeks postdelivery (Fingerhut et al., 1990;Ockene, 1993;Polanska et al., 2005; USDHHS, 2001). Postpartum smoking exposes the infant to environmental tobacco smoke, which is associated with a range of health problems in children including middle ear infection, asthma, sudden infant death syndrome, behavioral problems, and developmental delays (Charlton, 1994; USDHHS, 2006). Of course, by resuming smoking, the mother also reexposes herself to the myriad health risks associated with tobacco use. Given the high rate of self-quitting among pregnant smokers, as well as the success of interventions designed to motivate pregnant women to quit smoking (Melvin et al., 2000), pregnancy and the early postpartum period appear to offer unique opportunities to provide smoking relapseprevention interventions, although such efforts have met with at best modest success to date (Mullen, 2004).Recruiting participants for clinical trials can be challenging in general (e.g., Harris et al., 2003;Ross et al., 1999), and t...

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“…[23,38] Unfortunately, most spontaneous quitters return to smoking during postpartum. [16,23,26,41] The majority resume smoking within six months, [10,25] and this increases to as much as 80% within one year after delivery. [11] The rate of smoking relapse for low-income women is higher than all pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Smoking behaviors and abstinence in low-income pregnant women

Kessler

Alverson

2016

JNEP

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Background: Despite efforts to educate individuals about the hazards of smoking, pregnant women continue to smoke. In the literature, there is less evidence about successful abstinence strategies for low-income women. The purpose of this pilot study was to assess smoking behaviors and factors that support smoking abstinence in low-income pregnant women. Methods: Using a longitudinal design, quantitative and qualitative data were collected from pregnant women at a low-income community prenatal clinic. Based on the Transtheoretical model, all subjects received information about the harmful effects of smoking and secondhand exposure, while current smokers were given a "quit kit" and contacted up to one year post-delivery to evaluate smoking behaviors. Results: All subjects (N = 135) ranged in age from 18 to 41; 75% were not married; 78% had household incomes < $30,000; and the majority were African American (40%). Fifty-five (40.7%) never smoked while 77(57%) had a smoking history, of these 18(23%) were spontaneous quitters. Data indicated that 36% reported smoking during pregnancy, with the majority in pre-contemplation. After one year, 18% of current smokers quit. Conclusions: Without a specific plan, the majority were unable to successfully abstain. Rate of abstinence may have been further influenced because subjects began smoking at an early age and were unsuccessful at previous quit attempts. Providers must continue to educate pregnant women but also evaluate strategies that require few provider visits, are cost effective, focus on relapse prevention, and can successfully influence smoking abstinence in low-income pregnant women.

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Post-partum intention to resume smoking

Cited by 30 publications

References 20 publications

A Content Analysis of Attributions for Resuming Smoking or Maintaining Abstinence in the Post-partum Period

A Content Analysis of Attributions for Resuming Smoking or Maintaining Abstinence in the Post-partum Period

Clinical trials and tribulations: Lessons learned from recruiting pregnant ex-smokers for relapse prevention

Smoking behaviors and abstinence in low-income pregnant women

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