Socio-demographic factors and processes associated with stages of change for smoking cessation in pregnant versus non-pregnant women

Alessandra Buja,Giovanni Forza,Emanuela Guarnieri,Paolo Sandonà,Alessandra Zampieron,Federica Tognazzo

doi:10.1186/1472-6874-11-3

Abstract

BackgroundThe tobacco control community assumes that the most effective interventions are personalized. Nevertheless, little attention is paid to understanding differences between pregnant and non-pregnant European women in terms of the social factors that influence tobacco use and the processes of change used to quit smoking.MethodsThe study consecutively enrolled 177 pregnant women who acknowledged smoking the year before pregnancy and 177 non-pregnant women who acknowledged smoking the year before their clinic visit for a Pap test.ResultsWith respect to socio-demographic factors, the stages of change in pregnant women were associated with level of education, marital status, and the presence of roommates, partners and friends who smoke. In pregnant women, there was no statistically significant difference in the processes used to stop smoking among the stages of change. Furthermore, behavioral processes were higher in non-pregnant women than in pregnant women, and the difference was statistically significant in the advanced stages of behavioral change. Both pregnant and non-pregnant women showed higher levels of acceptance towards smoking in the earlier stages of change, but the acceptability of smoking in the pre-contemplative stage was higher in non-pregnant women. Greater craving was detected in non-pregnant vs. pregnant women at all stages and reached a statistically significant level at the pre-contemplative stage.ConclusionPregnancy is a favorable time to stop smoking since pregnant women are more likely to be in an advanced stage of behavioral change. Pregnant and non-pregnant women are distinct populations in the types and processes of change involved in smoking cessation. The intervention programs to promote smoking cessation and prevent relapses will need to take these differences into account.

Highlights

The tobacco control community assumes that the most effective interventions are personalized
Despite the preventive measures that have been implemented by various governments resulting in a reduction of cigarette smoking [1], tobacco smoking is still a major cause of both fatal and non-fatal diseases [2,3] and one of the major causes of avoidable illnesses and premature death in Europe [4]
Smoking cessation is a dynamic process with varying levels of motivation, intention, and confidence in quitting

Summary

Introduction

The tobacco control community assumes that the most effective interventions are personalized. Little attention is paid to understanding differences between pregnant and non-pregnant European women in terms of the social factors that influence tobacco use and the processes of change used to quit smoking. There are significant differences in smoking cessation and relapse between pregnant and non-pregnant smokers [6]. The motivations to quit smoking are different in pregnant women compared with non-pregnant women. The interventions for smoking cessation in non-pregnant women would be more effective if they could be stage- and process- specific, as described in the Transtheoretical Model (TTM) [11]. Much of the public health policy debate on smoking cessation has continued to focus on educational models of behavior change, which place individuals, rather than their environment, at the center of the debate [17]. A cohort study of women verified that being married or in a committed relationship is significantly associated with quitting and that living in rural or remote areas and having lower educational attainment are associated with continued smoking [19]

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Results

Conclusion