Smoking while using contraceptives: Risk perception and behavioral intention to quit

Abstract

Abstract Background Combining smoking with contraceptives containing ethinylestradiol increases the risk at several health issues, such as thrombosis, cardiovascular diseases and pulmonary embolism, especially when women are 35 years or older. It is important to inform women at an early stage and encourage them to quit smoking or change their contraceptive. The aim of this study is twofold. 1) using the Protection Motivation theory, we examine the predictors of the intention to quit smoking or change the currently used contraceptive method. 2) we provide insight into women's preferred ways to be informed and possible facilitators to change their behavior. Methods 68 Women, between 25 and 60 (mean age 30.6, sd 6.6; academic degree 78%), using the combination of smoking and ethinylestradiol containing contraceptives of a General Practice in Amsterdam, The Netherlands, filled in a questionnaire. Predictors were cigarette dependence (cds-5), perceived severity, vulnerability, response efficacy and self-efficacy. Outcome variables: intention to quit smoking or the current contraceptive. Results The average intention to quit smoking was higher (3,26 on a 5-point scale) than the average intention to quit the contraceptive method (2,47 on a 5-point scale). The predictors vulnerability, education level and reason for contraceptive use significantly predicted the intention to quit smoking (F(3, 65) = 40.22, p = .03), while self-efficacy and education level significantly predicted the intention to quit the contraceptive method. (F(2, 66) = 32.36, p =.02) Conclusions Risk perception stimulates women to quit smoking, while perceiving oneself capable of quitting or having alternatives is related to contraceptive change. A second wave of data is collected to enlarge the sample size. We add a qualitative study to get insight into strategies to alter women's behavior. This study will inform risk communicators and health care professionals, ultimately resulting in less women with this combination. Key messages Quitting smoking is potentially popular in a group of women with the risky combination of smoking with contraceptives containing ethinylestradiol. Risk perception stimulates women to quit smoking, while perceiving oneself capable of quitting or having alternatives is related to contraceptive change.