438 Pregnant smokers’ confidence in quitting is related to their level of nicotine addiction

Abstract

Cigarette smoking in pregnancy negatively impacts maternal and fetal health. Smoking cessation improves pregnancy outcomes, but rates of successful cessation remain low. We investigated the links between socioeconomic factors, depression scores, nicotine addiction measured via Fagerström score with confidence in quitting smoking and motivation to quit. This is a study within a trial, conducted within the Smoking cessation Through Optimisation of clinical care in Pregnancy (STOP) pragmatic randomised controlled trial. This is an RCT of the use of a dedicated smoking cessation antenatal clinic. At time of randomisation, current smokers complete an extensive behavioural questionnaire which forms the basis for this analysis. Groups were compared using Kendall rank correlation coefficient and ordered logistic regression. 436 women were randomised to the trial, of which 275 completed the behavioural questionnaire appropriately. There is a significant inverse relationship between confidence in quitting and Fagerström score, τb =0.39, p<0.01, suggesting that greater addiction to nicotine is associated with less confidence in quitting. There was no correlation with motivation to quit. On an ordered logistic regression analysis, confidence in quitting correlates with spend per week on tobacco, having smoked in a previous pregnancy, and educational level achieved. There was no correlation between depression scores and either confidence or motivation to quit. Women who are more addicted to nicotine are less confident in quitting, however they remain motivated to quit. Their confidence in quitting is also affected by their education level and having smoked in a previous pregnancy, but not by depression. This information can help in targeting future clinical trials in smoking cessation for pregnant women.