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Wen KY, Miller SM, Roussi P, Belton TD, Baman J, Kilby L, Hernandez E. A content analysis of self-reported barriers and facilitators to preventing postpartum smoking relapse among a sample of current and former smokers in an underserved population. HEALTH EDUCATION RESEARCH 2015; 30:140-151. [PMID: 25099776 PMCID: PMC4296888 DOI: 10.1093/her/cyu048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 07/15/2014] [Indexed: 06/03/2023]
Abstract
To characterize the barriers and facilitators thatprevent postpartum relapse and maintain smoking abstinence among a socioeconomically underserved population, recruited through Philadelphia-area women, infants, and children clinics, in-person interviews were conducted with 30 women who had quit smoking for one or more pregnancies in the past 3 years to retrospectively describe their attempts to remain abstinent during the postpartum period. Responses were analysed using the constructs from the Cognitive-Social Health Information Processing model, which identifies the cognitive, affective and behavioral factors involved in goal-oriented self-regulatory actions, in the context of a vulnerable population of women. Motherhood demands were a significant source of relapse stress. Stresses associated with partner and family relationships also contributed to relapse. The presence of other smokers in the environment was mentioned by many women in our sample as affecting their ability to remain smoke-free postpartum. Participants reported four main strategies that helped them to successfully cope with postpartum cravings and relapses, including being informed of smoking risks, maintaining goal-oriented thoughts, focusing on their concerns about the baby's health and receiving positive social support from families and friends. Results provide guidance for the design of smoking relapse interventions that may address the unique stressors reported by underserved postpartum women.
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Affiliation(s)
- Kuang-Yi Wen
- Cancer Prevention and Control, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA, Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA, Philadelphia Women, Infants and Children Program, Philadelphia, PA, USA and Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA, USA
| | - Suzanne M Miller
- Cancer Prevention and Control, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA, Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA, Philadelphia Women, Infants and Children Program, Philadelphia, PA, USA and Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA, USA
| | - Pagona Roussi
- Cancer Prevention and Control, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA, Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA, Philadelphia Women, Infants and Children Program, Philadelphia, PA, USA and Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA, USA
| | - Tanisha D Belton
- Cancer Prevention and Control, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA, Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA, Philadelphia Women, Infants and Children Program, Philadelphia, PA, USA and Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA, USA
| | - Jayson Baman
- Cancer Prevention and Control, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA, Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA, Philadelphia Women, Infants and Children Program, Philadelphia, PA, USA and Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA, USA
| | - Linda Kilby
- Cancer Prevention and Control, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA, Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA, Philadelphia Women, Infants and Children Program, Philadelphia, PA, USA and Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA, USA
| | - Enrique Hernandez
- Cancer Prevention and Control, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA, Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA, Philadelphia Women, Infants and Children Program, Philadelphia, PA, USA and Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA, USA
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Nguyen SN, Von Kohorn I, Schulman-Green D, Colson ER. The importance of social networks on smoking: perspectives of women who quit smoking during pregnancy. Matern Child Health J 2012; 16:1312-8. [PMID: 21989676 DOI: 10.1007/s10995-011-0896-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
While up to 45% of women quit smoking during pregnancy, nearly 80% return to smoking within a year after delivery. Interventions to prevent relapse have had limited success. The study objective was to understand what influences return to smoking after pregnancy among women who quit smoking during pregnancy, with a focus on the role of social networks. We conducted in-depth, semi-structured interviews during the postpartum hospital stay with women who quit smoking while pregnant. Over 300 pages of transcripts were analyzed using qualitative methods to identify common themes. Respondents [n = 24] were predominately white (63%), had at least some college education (54%) and a mean age of 26 years (range = 18-36). When reflecting on the experience of being a smoker who quit smoking during pregnancy, all participants emphasized the importance of their relationships with other smokers and the changes in these relationships that ensued once they quit smoking. Three common themes were: (1) being enmeshed in social networks with prominent smoking norms (2) being tempted to smoke by members of their social networks, and (3) changing relationships with the smokers in their social networks as a result of their non-smoking status. We found that women who quit smoking during pregnancy found themselves confronted by a change in their social network since most of those in their social network were smokers. For this reason, smoking cessation interventions may be most successful if they help women consider restructuring or reframing their social network.
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Affiliation(s)
- Stephanie N Nguyen
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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