Supporting Underserved Pregnant Women through the Stages of Change to Promote Smoking Abstinence

Saturday, 16 November 2013

Theresa A. Kessler, PhD, RN, ACNS-BC, CNE
Elise M. Alverson, DNP, RN, FNP-BC, CNE
Michelle DeYoung, BSN, student
Nicole Arena, BSN Student
College of Nursing, Valparaiso University, Valparaiso, IN

Learning Objective 1: The learner will be able to identify the smoking patterns of underserved pregnant women.

Learning Objective 2: The learner will be able to describe the use of the Transtheoretical model in promoting change in smoking behaviors of underserved pregnant women.

Despite efforts to warn women about the hazards of smoking, underserved pregnant women continue to smoke. Approximately 13% of women in the U.S. reported smoking during pregnancy (CDC, 2012). The purpose of this pilot study was to assess smoking behaviors and support smoking abstinence in underserved pregnant women. Using a longitudinal design, women were recruited from a community prenatal center. Interventions were developed based on the Transtheoretical model and were designed to support the subjects’ movement along the stages of change. Subjects willing to quit were given a smoking abstinence “quit kit”. For subjects not contemplating smoking abstinence, information about the harmful effects of smoking was distributed to encourage movement towards quitting. Subjects who were smoking were followed throughout their pregnancy and up to one year after delivery. Subjects (N = 135) ranged in age from 18 to 41. 71% were single, and 63% had household incomes < $20,000 per year. Subjects were primarily African American (40%). 56% had previously smoked, and 35% were self-identified as current smokers. For those women continuing to smoke (n = 28), 6 were not considering quitting (pre-contemplation), 15 intended to quit (contemplation), and 5 had an action plan (preparation). Six weeks post-delivery (n = 12), one woman quit smoking and the others were intending to quit. Six months post-delivery (n = 7), two women quit smoking and the remaining smokers were intending to quit. One year post-delivery (n = 9), one woman quit smoking, and of the remaining smokers only six intended to quit. The smoking abstinence strategy led to minimal changes in smoking behaviors. Results will add to the growing body of evidence about smoking patterns of underserved pregnant women and factors that may influence smoking abstinence.