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Improving Behavioral Support for Smoking Cessation in Pregnancy: What Are the Barriers to Stopping and Which Behavior Change Techniques Can Influence Them? Application of Theoretical Domains Framework

Author

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  • Katarzyna A Campbell

    (Division of Primary Care, University of Nottingham, Room 1406, Tower Building, University Park, Nottingham NG7 2RD, UK)

  • Libby Fergie

    (Division of Primary Care, University of Nottingham, Room 1406, Tower Building, University Park, Nottingham NG7 2RD, UK)

  • Tom Coleman-Haynes

    (Division of Primary Care, University of Nottingham, Room 1406, Tower Building, University Park, Nottingham NG7 2RD, UK)

  • Sue Cooper

    (Division of Primary Care, University of Nottingham, Room 1406, Tower Building, University Park, Nottingham NG7 2RD, UK)

  • Fabiana Lorencatto

    (Centre for Behaviour Change, University College London, London WC1E 7HB, UK)

  • Michael Ussher

    (Division of Population Health Sciences and Education, St George’s University of London, London SW17 ORE, UK
    Institute of Social Marketing, University of Stirling, Stirling, FK9 4LA Scotland, UK)

  • Jane Dyas

    (Division of Primary Care, University of Nottingham, Room 1406, Tower Building, University Park, Nottingham NG7 2RD, UK)

  • Tim Coleman

    (Division of Primary Care, University of Nottingham, Room 1406, Tower Building, University Park, Nottingham NG7 2RD, UK)

Abstract

Behavioral support interventions are used to help pregnant smokers stop; however, of those tested, few are proven effective. Systematic research developing effective pregnancy-specific behavior change techniques (BCTs) is ongoing. This paper reports contributory work identifying potentially-effective BCTs relative to known important barriers and facilitators (B&Fs) to smoking cessation in pregnancy; to detect priority areas for BCTs development. A Nominal Group Technique with cessation experts ( n = 12) elicited an expert consensus on B&Fs most influencing women’s smoking cessation and those most modifiable through behavioral support. Effective cessation interventions in randomized trials from a recent Cochrane review were coded into component BCTs using existing taxonomies. B&Fs were categorized using Theoretical Domains Framework (TDF) domains. Matrices, mapping BCT taxonomies against TDF domains, were consulted to investigate the extent to which BCTs in existing interventions target key B&Fs. Experts ranked ‘smoking a social norm’ and ‘quitting not a priority’ as most important barriers and ‘desire to protect baby’ an important facilitator to quitting. From 14 trials, 23 potentially-effective BCTs were identified (e.g., ‘information about consequences). Most B&Fs fell into ‘Social Influences’, ‘Knowledge’, ‘Emotions’ and ‘Intentions’ TDF domains; few potentially-effective BCTs mapped onto every TDF domain. B&Fs identified by experts as important to cessation, are not sufficiently targeted by BCT’s currently within interventions for smoking cessation in pregnancy.

Suggested Citation

  • Katarzyna A Campbell & Libby Fergie & Tom Coleman-Haynes & Sue Cooper & Fabiana Lorencatto & Michael Ussher & Jane Dyas & Tim Coleman, 2018. "Improving Behavioral Support for Smoking Cessation in Pregnancy: What Are the Barriers to Stopping and Which Behavior Change Techniques Can Influence Them? Application of Theoretical Domains Framework," IJERPH, MDPI, vol. 15(2), pages 1-20, February.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:2:p:359-:d:132323
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    References listed on IDEAS

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    1. Walsh, R.A. & Redman, S. & Brinsmead, M.W. & Byme, J.M. & Melmelh, A., 1997. "A smoking cessation program at a public antenatal clinic," American Journal of Public Health, American Public Health Association, vol. 87(7), pages 1201-1204.
    2. Windsor, R.A. & Cutter, G. & Morris, J. & Reese, Y. & Manzella, B. & Bartlett, E.E. & Samuelson, C. & Spanos, D., 1985. "The effectiveness of smoking cessation methods for smokers in public health maternity clinics: A randomized trial," American Journal of Public Health, American Public Health Association, vol. 75(12), pages 1389-1392.
    3. Ershoff, D.H. & Mullen, P.D. & Quinn, V.P., 1989. "A randomized trial of a serialized self-help smoking cessation program for pregnant women in an HMO," American Journal of Public Health, American Public Health Association, vol. 79(2), pages 182-187.
    4. Katarzyna Anna Campbell & Katharine Anna Bowker & Felix Naughton & Melanie Sloan & Sue Cooper & Tim Coleman, 2016. "Antenatal Clinic and Stop Smoking Services Staff Views on “Opt-Out” Referrals for Smoking Cessation in Pregnancy: A Framework Analysis," IJERPH, MDPI, vol. 13(10), pages 1-12, October.
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    Cited by:

    1. Libby Fergie & Tim Coleman & Michael Ussher & Sue Cooper & Katarzyna A Campbell, 2019. "Pregnant Smokers’ Experiences and Opinions of Techniques Aimed to Address Barriers and Facilitators to Smoking Cessation: A Qualitative Study," IJERPH, MDPI, vol. 16(15), pages 1-15, August.
    2. Eleanor Lutman-White & Riya Patel & Lauren Bell & Deborah Lycett & Kelly Hayward & Ruth Sampson & Janani Arulrajah & Maxine Whelan, 2024. "Provision of E-Cigarettes for Smoking Cessation in Pregnancy: Perceptions and Experiences of Pregnant Women from Two UK Sites," IJERPH, MDPI, vol. 21(4), pages 1-12, April.
    3. Fizzah B. Abidi & Libby Laing & Sue Cooper & Tim Coleman & Katarzyna A. Campbell, 2020. "Experts’ Views on Behaviour Change Techniques for Smoking Cessation in Pregnancy: A Qualitative Study," IJERPH, MDPI, vol. 17(21), pages 1-13, October.
    4. Kate Frazer & Patricia Fitzpatrick & Mary Brosnan & Anne Marie Dromey & Sarah Kelly & Michael Murphy & Denise O’Brien & Cecily C. Kelleher & Fionnuala M. McAuliffe, 2020. "Smoking Prevalence and Secondhand Smoke Exposure during Pregnancy and Postpartum—Establishing Risks to Health and Human Rights before Developing a Tailored Programme for Smoking Cessation," IJERPH, MDPI, vol. 17(6), pages 1-11, March.
    5. Lisa McDaid & Ross Thomson & Joanne Emery & Tim Coleman & Sue Cooper & Lucy Phillips & Felix Naughton, 2021. "Agreement and Disparities between Women and Stop-Smoking Specialists about How to Promote Adherence to Nicotine Replacement Therapy in Pregnancy," IJERPH, MDPI, vol. 18(9), pages 1-16, April.
    6. Katharine Bowker & Michael Ussher & Sue Cooper & Sophie Orton & Tim Coleman & Katarzyna Anna Campbell, 2020. "Addressing and Overcoming Barriers to E-Cigarette Use for Smoking Cessation in Pregnancy: A Qualitative Study," IJERPH, MDPI, vol. 17(13), pages 1-13, July.
    7. Ross Thomson & Lisa McDaid & Joanne Emery & Felix Naughton & Sue Cooper & Jane Dyas & Tim Coleman, 2019. "Knowledge and Education as Barriers and Facilitators to Nicotine Replacement Therapy Use for Smoking Cessation in Pregnancy: A Qualitative Study with Health Care Professionals," IJERPH, MDPI, vol. 16(10), pages 1-13, May.
    8. Tracey J. Brown & Sarah Gentry & Linda Bauld & Elaine M. Boyle & Paul Clarke & Wendy Hardeman & Richard Holland & Felix Naughton & Sophie Orton & Michael Ussher & Caitlin Notley, 2020. "Systematic Review of Behaviour Change Techniques within Interventions to Reduce Environmental Tobacco Smoke Exposure for Children," IJERPH, MDPI, vol. 17(21), pages 1-14, October.

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