Patient-provider communication about cigarette and e-cigarette use during pregnancy: Adaptation and validation of frequency and quality of communication measures among a sample of pregnant patients.

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Quality of patient-provider communication regarding tobacco use may encourage cessation that could lead to improved health outcomes for mothers and children. However, currently there are no validated measures of frequency and quality of patient-provider communication about cigarettes and e-cigarettes. The objective of this study was to adapt and validate measures of frequency and quality of patient-provider communication about smoking and e-cigarette use among a sample of pregnant mothers who currently smoked. An online sample of US pregnant women who reported past 30-day smoking were recruited to complete a cross-sectional, online survey (n=267). An exploratory factor analysis examined the factor structure of four measures of frequency and quality of patient-provider communication about cigarettes and e-cigarettes among those who reported prior communication with their provider about cigarettes and e-cigarettes (n=170). Relationships between measures were explored, and a logistic regression explored each measure's association with intention to switch from cigarettes to e-cigarettes. Items measuring the frequency of communication loaded onto one factor for both cigarettes and e-cigarettes (α=0.88). Quality of communication loaded onto two factors for both cigarettes and e-cigarettes, termed active communication and internalized perception. Internalized perceptions of communication quality about cigarettes (β= -0.32, p<0.002), active communication (β=0.46, p<0.02), and internalized perceptions of communication about e-cigarettes (β= -0.36, p<0.001) were related to intention to switch, in separated models. Quality conversations between healthcare providers and pregnant patients is likely more important for behavioral decision-making than the frequency of communication.