SAFE BABIES: The Determinants of Postpartum Smoke-free and Relapse States


Objective: This qualitative study explores factors relating to smoking cessation among women who quit smoking during pregnancy, and their decisions to remain smoke-free or relapse during pregnancy and after delivery. Methods: Eligible women enrolled who were attending family medicine or obstetric/gynecology clinics in Central North Carolina between February 2001 and May 2003, had quit smoking (cotinine verified) before thirty weeks gestation, and agreed to a face-to-face interview assessment 4 months postpartum. This reports documents interviews with the first 57 women (24 smoke-free, 33 relapse) who completed the study. Results: While similar themes explained the cessation process for women who relapsed and those remaining smoke-free, different factors explained relapse and relapse prevention. Fetal health was the motivating factor for cessation before and during pregnancy. Stress, socializing with smokers, cravings, weight gain and return to work postpartum tempted both groups to smoke. The smoke-free group overcame temptations through strong social/spousal support, growing self-confidence, and internalized beliefs in improved maternal and infant health. The relapse group lacked this level of social support and perception of maternal health benefits. Both groups established rules to limit infant exposure to second-hand smoke. Conclusion: Recommendations for relapse prevention include clinically emphasizing maternal and infant health, advice on resisting smoking temptations, increasing the incentive to remain quit, providing stress relief alternatives, providing support services, and reducing access to cigarettes. Community interventions targeting pregnant women and postpartum mothers who have quit smoking should compensate for varying levels of support, incorporate family, friends and spouses, and connect women with other ex-smokers.Master of Public Healt

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This paper was published in Carolina Digital Repository.

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