Supporting Underserved Pregnant Women Through Smoking Cessation

Monday, 22 July 2013

Theresa A. Kessler, PhD, RN, ACNS-BC, CNE
Elise M. Alverson, DNP, RN, FNP-BC, CNE
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.

Purpose: Despite efforts to warn women about the hazards of smoking, underserved pregnant women continue to smoke. The purpose of this pilot study was to assess smoking behaviors and support smoking cessation in underserved pregnant women.

Methods: 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 cessation “quit kit”. For subjects not contemplating smoking cessation, 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.

Results: 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 planning to quit. Six months post-delivery (n = 7), two women quit smoking and the remaining smokers were planning to quit. One year post-delivery (n = 9), one woman quit smoking and of the remaining smokers only six planned to quit.

Conclusion: Results will add to the growing body of evidence about smoking patterns of underserved pregnant women and factors that help maintain smoking cessation.