Academic Scientific JournalsSocio-demographic and motivational correlates of smoking status at term and postpartum
Keywords:
pregnancy, self-efficacy, theory of planned behaviour, smoking relapse, perceived behavioural controlAbstract
Background
Tobacco consumption during pregnancy has consequences for pregnant women and their fetus, as well as during the postnatal period. Many women stop their tobacco consumption during pregnancy, but statistics vary about the exact proportion, and a non-negligible number of them are still smoking at term. Moreover, tobacco relapse after birth is frequent. This study aims to provide epidemiological indicators about tobacco consumption at term and post-partum relapse in Switzerland, and test risks factors associated with tobacco consumption at term, including Theory of Planned Behaviour variables for the motivational correlates. Losses to follow-up precluded testing risk factors associated with post-partum relapse.
Participants and procedure
Respondents were recruited at the pre-birth consultations at the hospital and answered the initial survey. They were contacted by email in the post-partum period two and six months after childbirth.
Results
10.6% of our sample were still smoking at the end of their pregnancy. The low-end estimate of relapse is 21.2% at two months (the high-end estimate being 74% after six months, using the worst-case scenario). Higher education level, income, and multiparity were descriptively associated with less tobacco consumption at term. Perceived behavioural control was the motivational variable differing the most between smokers and non-smokers, and with the broadest variance. Scores of attitudes and subjective norms had higher levels and were more consensual.
Conclusions
Incidence of tobacco consumption during pregnancy and during the post-partum period is problematic in Switzerland. One promising avenue is increasing pregnant women’s perceived behavioural control toward smoking cessation during pregnancy and long-term abstinence.
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References
Ajzen, I. (1985). From intentions to actions: a theory of planned behavior. In J. Kuhi & J. Beckmann (Eds.), Action – control: From cognition to behavior (pp. 11–39). Springer.
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.
Alamar, B., & Glantz, S. A. (2006). Effect of increased social unacceptability of cigarette smoking on reduction in cigarette consumption. American Journal of Public Health, 96, 1359–1363. https:// doi.org/10.2105/AJPH.2005.069617.
Ben Natan, M., Golubev, V., & Shamrai, V. (2010). Smoking during pregnancy: Analysis of influencing factors using the theory of planned behaviour. International Nursing Review, 57, 388–394. https:// doi.org/10.1111/j.1466-7657.2010.00807.x.
Benachi, A., Luton, D., Mandelbrot, L., & Picone, O. (Eds.). (2014). Pathologies maternelles et grossesse [Maternal pathology and pregnancy]. Elsevier.
Brown, T. J., Hardeman, W., Bauld, L., Holland, R., Maskrey, V., Naughton, F., Orton, S., Ussher, M., & Notley, C. (2019). A systematic review of behaviour change techniques within interventions to prevent return to smoking postpartum. Addictive Behaviors, 92, 236–243. https://doi.org/10.1016/j.addbeh.2018.12.031.
Cornuz, J., Jacot Sadowski, I., & Humair, J. P. (2015). Conseil médical aux fumeurs et fumeuses. Document de référence pour les médecins [Medical advice for smokers. Reference document for doctors]. Berne: Vivre sans tabac, Programme national d’arrêt du tabagisme.
Crutzen, R., & Peters, G. J. Y. (2019). The book of behavior change (1st ed.). Retrieved from https:// bookofbehaviorchange.com De Wilde, K., Maes, L., Boudrez, H., Tency, I., Temmerman, M., & Clays, E. (2017). Analysis of smoking cessation beliefs in pregnant smokers and ex-smokers using the theory of planned behavior. Journal of Public Health, 25, 267–274. https:// doi.org/10.1007/s10389-016-0784-x.
Desrichard, O., Moussaoui, L. S., Blondé, J., Felder, M., Riedo, G., Folly, L., & Falomir-Pichastor, J. M. (2020). How effective are planned national collective smoking cessation programs? Success rate based on the evaluation of the Swiss program “I quit smoking with Facebook on March 21”. Manuscript submitted for publication.
Diamanti, A., Papadakis, S., Schoretsaniti, S., Rovina, N., Vivilaki, V., Gratziou, C., & Katsaounou, P. A. (2019). Smoking cessation in pregnancy: an update for maternity care practitioners. Tobacco Induced Diseases, 17, 57–57. https://doi.org/10.18332/tid/109906.
Dupraz, J., Graff, V., Barasche, J., Etter, J., & Boulvain, M. (2013). Tobacco and alcohol during pregnancy: Prevalence and determinants in Geneva in 2008. Swiss Medical Weekly, 143, 13795. https://doi. org/10.4414/smw.2013.13795.
El-Khoury, F., Sutter-Dallay, A. L., Van Der Waerden, J., Surkan, P., Martins, S., Keyes, K., de Lauzon-Guillain, B., Charles, M. A., & Melchior, M. (2017). Smoking trajectories during the perinatal period and their risk factors: The nationally representative French ELFE (Etude Longitudinale Française Depuis l’Enfance) birth cohort study. European Addiction Research, 23, 194–203. https://doi.org/10.1159/000479022.
Espiand-Marçais, C., Quantin, X., Toubin, R. M., Boulot, P., & Molénat, F. (2014). Enceinte et fumeuse: Mieux comprendre pour mieux accompagner [Smoking during pregnancy: Understand better for a better help]. Revue de Médecine Périnatale, 6, 69–75. https://doi.org/10.1007/s12611-014-0262-4.
Francis, J., Eccles, M. P., Johnston, M. W., Walker, A. E., Grimshaw, J. M., Foy, R., Kaner, E. F. S., Smith, L., & Bonetti, D. (2004). Constructing questionnaires based on the theory of planned behaviour: a manual for health services researchers. Newcastle: Centre for Health Services Research, University of Newcastle upon Tyne.
Gantt, C. J. (2001). The theory of planned behavior and postpartum smoking relapse. Journal of Nursing Scholarship, 33, 337–341. https://doi.org/10.1111/ j.1547-5069.2001.00337.x.
Germeroth, L. J., Wang, Z., Emery, R. L., Cheng, Y., & Levine, M. D. (2019). The role of self-efficacy and motivation in postpartum sustained smoking abstinence. Women’s Health Issues, 29, 259–266. https://doi.org/10.1016/j.whi.2019.03.006.
Godding, V. (2010). Tabagisme prénatal. Recommandations de bonne pratique pour les gynécologues obstétriciens [Antenatal tobacco use. Good practice recommandations for gynecologist obstetricians]. Brussels: FARES. Godin, G., Valois, P., Lepage, L., & Desharnais, R. (1992). Predictors of smoking behaviour: an application of Ajzen’s theory of planned behaviour. Addiction, 87, 1335–1343. https://doi.org/10.1111/j.1360-0443.1992. tb02742.x.
Green, L. W., & Kreuter, M. (2005). Health program planning: an educational and ecological approach. McGraw-Hill Higher Education. Human Behaviour Change Projects (2018). The Theory and Techniques Tool. Retrieved from https://theoryandtechniquetool.humanbehaviourchange.org.
Keller, R., Radtke, T., Füllemann, D., Krebs, H., & Hornung, R. (2009). Tabagisme et grossesse. Monitorage sur le tabac – Enquête suisse sur le tabagisme [Tobacco use and pregnancy. Tobacco monitoring Switzerland]. Retrieved from http://www.stop-tabac.ch/fr/images/stories/documents_stop_tabac/ tabagisme%20et%20grossesse%20ofsp.pdf.
Loring, B. (2014). Tobacco and inequities. World Health Organization. Meernik, C., & Goldstein, A. O. (2015). A critical review of smoking, cessation, relapse and emerging research in pregnancy and post-partum. British Medical Bulletin, 114, 135–146. https://doi.org/10.1093/ bmb/ldv016.
Notley, C., Blyth, A., Craig, J., Edwards, A., & Holland, R. (2015). Postpartum smoking relapse – a thematic synthesis of qualitative studies. Addiction, 110, 1712–1723. https://doi.org/10.1111/add.13062.
Office fédéral de la santé publique (OFSP) (2018). Fiche d’information – Le tabagisme pendant la grossesse en Suisse [Information sheet – Tobacco use during pregnancy in Switzerland]. Retrieved from https:// www.suchtmonitoring.ch/docs/library/office_federal_de_la_sante_publique_ofsp_1tauq0msi87m.pdf.
Office fédéral de la santé publique (OFSP) (2019). Faits & chiffres: Tabac [Facts & data: Tobacco]. Retrieved from https://www.bag.admin.ch/bag/fr/ home/zahlen-und-statistiken/zahlen-fakten-zusucht/zahlen-fakten-zu-tabak.html.
Parascandola, M., Klein, A., & Bromberg, J. (2019). Systematic review and meta-analysis of maternal secondhand smoke exposure and neonatal outcomes. Journal of Health Inequalities, 5, 53–66. https://doi.org/10.5114/jhi.2019.87838.
Patrick, D. L., Cheadle, A., Thompson, D. C., Diehr, P., Koepsell, T., & Kinne, S. (1994). The validity of selfreported smoking: a review and meta-analysis. American Journal of Public Health, 84, 1086–1093. https://doi.org/10.2105/AJPH.84.7.1086.
Riaz, M., Lewis, S., Naughton, F., & Ussher, M. (2018). Predictors of smoking cessation during pregnancy: a systematic review and meta-analysis. Addiction, 113, 610–622. https://doi.org/10.1111/add.14135.
Rumrich, I., Vähäkangas, K., Viluksela, M., Gissler, M., de Ruyter, H., & Hänninen, O. (2020). Effects of maternal smoking on body size and proportions at birth: a register-based cohort study of 1.4 million births. BMJ Open, 10, e033465. https:// doi.org/10.1136/bmjopen-2019-033465.
Schaap, M. M., Kunst, A. E., Leinsalu, M., Regidor, E., Espelt, A., Ekholm, O., Helmert, U., Klumbiene, J., & Mackenbach, J. P. (2009). Female ever-smoking, education, emancipation and economic development in 19 European countries. Social Science & Medicine, 68, 1271–1278. https://doi.org/10.1016/j. socscimed.2009.01.007.
Sheeran, P. (2002). Intention-behavior relations: a conceptual and empirical review. European Review of Social Psychology, 12, 1–36. https://doi. org/10.1080/14792772143000003.
Steinmetz, H., Knappstein, M., Ajzen, I., Schmidt, P., & Kabst, R. (2016). How effective are behavior change interventions based on the theory of planned behavior? A three-level meta-analysis. Zeitschrift Für Psychologie, 224, 216–233. https:// doi.org/10.1027/2151-2604/a000255.
The Jamovi Project (2019). Jamovi (1.0) [Computer software]. Retrieved from https://www.jamovi.org Topa, G., & Moriano, J. A. (2010). Theory of planned behavior and smoking: meta-analysis and SEM model. Substance Abuse and Rehabilitation, 1, 23–33. https://doi.org/10.2147/SAR.S15168.
WHO (2013). WHO recommendations for the prevention and management of tobacco use and secondhand smoke exposure in pregnancy. World Health Organization.
Willi, C., De Torrenté de la Jara, G., & Cornuz, J. (2006). Cycles de vie d’une femme et tabac [Women’s life cycles and tobacco]. Revue Médicale Suisse, 2, article 31475. Retrieved from https://www.revmed.ch/ RMS/2006/RMS-72/31475.
Wray, J. M., Gass, J. C., Miller, E. I., Wilkins, D. G., Rollins, D. E., & Tiffany, S. T. (2016). A comparative evaluation of self-report and biological measures of cigarette use in nondaily smokers. Psychological Assessment, 28, 1043–1050. https://doi.org/10.1037/ pas0000227.
Yancey, A. K., Ortega, A. N., & Kumanyika, S. K. (2006). Effective recruitment and retention of minority research participants. Annual Review of Public Health, 27, 1–28. https://doi.org/10.1146/annurev. publhealth.27.021405.102113.
