Predictors of Smoking Cessation Counseling Adherence in a Socioeconomically Disadvantaged Sample of Pregnant Women

Abstract

Implementing and evaluating smoking cessation interventions in underserved populations has been found difficult due to high rates of non-adherence to the prescribed protocol. To understand better the barriers to cessation participation, we studied low-income inner-city pregnant women who were enrolled in either a standard or highly intensive quit smoking counseling program. The results showed that 1) in the prenatal phase, non-attendance was predicted by a greater number of cigarettes smoked per day; 2) in the postpartum follow-up phase, non-attendance was predicted by lower educational level and higher self-efficacy for quitting smoking; and 3) participants with more children living at home were at increased risk of rescheduling the postpartum follow-up session. These findings suggest that innovative delivery strategies are needed more effectively to assess and address risk factors for non-adherence to smoking cessation trials among underserved minority pregnant/postpartum smokers.

Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women

“…Thus, there is the possibility that the study was underpowered for the follow-up points. Recruiting and retaining underserved women into smoking cessation programs, particularly into intensive and temporally demanding interventions, has been recognized as a challenge in the literature (Katz et al, 2008; Paskett et al, 2008; Ussher et al, 2006; Wen et al, 2012). …”

Smoking behaviors and abstinence in low-income pregnant women

“…Not only can these strategies be used in a variety of settings, they are inexpensive, do not require a prescription, and can be individualized based on preference. Providing these additional measures in the form of a "quit kit" as part of routine care can be an inexpensive strategy distributed during visits to assist women in adopting these behaviors Since low-income women have a high rate of failure to attend intervention sessions and HCP visits, [45] counseling interventions must require few interactions with HCPs. While not effective in this sample, a phone based counseling intervention or "quit line" adds flexibility and provides access to evidence-based strategies which could support smoking abstinence.…”

Toward Enhancing Treatment for Pregnant Smokers: Laying the Groundwork for the Use of Complementary and Alternative Medicine Approaches

“…Available approaches also fail to significantly improve quit rates among pregnant women (Hebert, 2004), with sustained quit rates for some effective approaches rarely exceeding 20% (Wen, Miller, Lazev, Fang, & Hernandez, 2012). Further, available approaches also fail to even reach most women who are in need of treatment for a variety of reasons.…”

“…For example, psychosocial smoking cessation programs are often delivered in multiple sessions and typically involve professional counseling and ongoing support. However, drop-out rates are high and treatment sessions are frequently rescheduled or missed, particularly among underserved women (Wen et al, 2012). Therefore, it can be difficult to adequately assess the effectiveness of smoking cessation interventions for some pregnant women, and interventions that are effective may not be as potent if only a portion of the treatment is delivered (Wen et al, 2012).…”

“…However, drop-out rates are high and treatment sessions are frequently rescheduled or missed, particularly among underserved women (Wen et al, 2012). Therefore, it can be difficult to adequately assess the effectiveness of smoking cessation interventions for some pregnant women, and interventions that are effective may not be as potent if only a portion of the treatment is delivered (Wen et al, 2012). Overall, most women who smoke during pregnancy neither seek nor receive treatment (Goldenberg et al, 2000).…”