Predictors of Postpartum Return to Smoking: A Systematic Review

Orton, Sophie; Coleman, Tim; Coleman‐Haynes, Tom; Ussher, Michael

doi:10.1093/ntr/ntx163

Cited by 59 publications

(76 citation statements)

References 65 publications

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“…Finally, women who did (vs. did not) relapse postpartum were nearly twice as likely to have a partner who continued smoking postpartum. These findings are consistent with prior studies [24,25,27,32,37] and provide more insight into the relationship between the timing of the partner's smoking behavior and maternal smoking status around pregnancy (e.g., women who smoked during the entire pregnancy were nearly 4.5 times more likely to have a partner who decreased their smoking or quit smoking during pregnancy compared to women who did not smoke during the entire pregnancy).…”

Section: Discussion/conclusionsupporting

confidence: 90%

Smoking Behavior of Women Before, During, and after Pregnancy: Indicators of Smoking, Quitting, and Relapse

et al. 2019

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Background: Smoking cessation during pregnancy and preventing relapse postpartum is a pivotal public health priority. Objectives: This study examined the risk and protective indicators of women who (a) smoke before pregnancy, (b) smoke during the entire pregnancy, (c) successfully quit smoking during pregnancy, and (d) relapse postpartum. Method: This paper reports secondary analyses of the Dutch population-based Monitor on Substance Use and Pregnancy (2016). A representative sample of mothers of young children (n = 1,858) completed questionnaires at youth health care centers. Bivariate and multivariate logistic regression analyses were conducted. Results: Main results showed that women’s smoking around pregnancy was strongly associated with the partner’s smoking status before pregnancy, partner’s change in smoking during pregnancy, and partner’s change in smoking postpartum. Women’s educational level and cannabis use before pregnancy were also related with women’s smoking before and during pregnancy. Women’s intensity of alcohol use before pregnancy was ambiguously related with women’s smoking before and during pregnancy. Conclusions: One of the key findings of this study suggests that it is essential that partners quit smoking before pregnancy and do not smoke during pregnancy. If partners continue smoking during pregnancy, they should quit smoking postpartum. Health care professionals can play an important role in addressing partners’ smoking and giving them evidence-based cessation support before, during, and after pregnancy.

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Section: Discussion/conclusionsupporting

confidence: 90%

Smoking Behavior of Women Before, During, and after Pregnancy: Indicators of Smoking, Quitting, and Relapse

et al. 2019

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“…Pregnant and postpartum smokers tend to be of a lower socioeconomic status, less well educated and have lower levels of support ( Chamberlain et al, 2017 ; Orton et al, 2018 ). Future interventions and their BCT components need to be tailored to address the specific needs and cultural identity of these high-risk groups.…”

Section: Discussionmentioning

confidence: 99%

“…Randomised controlled trials published prior to 2015 were identified by handsearching Jones ( Jones et al, 2016 ) and other recent pertinent systematic reviews of smoking cessation in pregnancy ( Chamberlain et al, 2017 ; Coleman et al, 2015 ) and postpartum relapse prevention interventions ( Notley et al, 2015 ; Orton et al, 2018 ).…”

Section: Methodsmentioning

confidence: 99%

“…Most women who quit smoking during pregnancy wish to remain abstinent, but a high proportion return to smoking postpartum ( Chamberlain et al, 2017 ; Jones, Lewis, Parrott, Wormall, & Coleman, 2016 ; Lumley et al, 2009 ). Postpartum women are particularly vulnerable to smoking relapse due to factors such as perception of no longer needing to protect the baby, stress of dealing with a new infant, lack of confidence in remaining quit, nicotine dependence, living with a smoking partner, and a desire to return to their pre-pregnancy identity ( Flemming et al, 2015 ; Notley et al, 2015 ; Orton, Coleman, Coleman-Haynes, & Ussher, 2018 ; Riaz, Lewis, Naughton, & Ussher, 2018 ). Rates of return to smoking in the literature vary due to specific population characteristics and variation in success of any provided intervention ( Fang, Goldstein, Butzen, et al, 2004 ; Jones et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, children of smoking mothers are twice as likely to become smokers themselves, perpetuating the cycle ( Leonardi-Bee, Jere, & Britton, 2011 ). The prevalence of smoking during pregnancy is higher in more disadvantaged groups ( Chamberlain et al, 2017 ; Coleman, Chamberlain, Davey, Cooper, & Leonardi-Bee, 2015 ) and being less well educated has been identified as an important predictor of relapse postpartum ( Orton et al, 2018 ). Despite these inequalities, health and cost implications; there is no routine provision of support to prevent relapse due to a lack of evidence-based interventions ( Hajek et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of behaviour change techniques within interventions to prevent return to smoking postpartum

Brown

Hardeman

Bauld

et al. 2019

Addictive Behaviors

Self Cite

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Introduction There is no routine support to prevent postpartum smoking relapse, due to lack of effective interventions. Previous reviews have identified behaviour change techniques (BCTs) within pregnancy cessation trials to specify which components might be incorporated into more effective interventions, but no reviews have identified BCTs for prevention of smoking relapse postpartum. We reviewed BCTs and potential delivery modes, to inform future interventions. Methods We searched Medline and EMBASE from January 2015–May 2017; and identified trials published before 2015 by handsearching systematic reviews. We included RCTs where: i) ≥1 intervention component aimed to maintain smoking abstinence versus a less intensive intervention; ii) participants included pregnant or postpartum smoking quitters; iii) smoking status was reported in the postpartum period. We extracted trial characteristics and used the Behaviour Change Technique Taxonomy v1 to extract BCTs. We aimed to identify ‘promising’ BCTs i.e. those frequently occurring and present in ≥2 trials that demonstrated long-term effectiveness (≥6 months postpartum). Data synthesis was narrative. Results We included 32 trials, six of which demonstrated long-term effectiveness. These six trials used self-help, mainly in conjunction with counselling, and were largely delivered remotely. We identified six BCTs as promising: ‘problem solving’, ‘information about health consequences’, ‘information about social and environmental consequences’, ‘social support’, ‘reduce negative emotions’ and ‘instruction on how to perform a behaviour’. Conclusions Future interventions to prevent postpartum smoking relapse might include these six BCTs to maximise effectiveness. Tailored self-help approaches, with/without counselling, may be favourable modes of delivery of BCTs. Registration: PROSPERO CRD42018075677.

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Persistent Barriers to Smoking Cessation Among Urban, Underserved Women: A Feasibility Study of Tailored Barriers Text Messages

Tagai

Miller

Belfiglio

et al. 2020

Matern Child Health J

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Objectives: Despite health risks for themselves and their children, urban underserved women smoke at high rates postpartum. The postpartum period is a stressful transition time that presents unique barriers to sustained cessation. There is limited extant evidence of efficacious psychosocial programs to maintain postpartum smoking cessation.Methods: Guided by the Cognitive-Social Health Information Processing model, we explored the feasibility of TxT2Commit, a text-messaging intervention designed to prevent postpartum smoking relapse. Participants (n=43) received supportive cessation-focused text messages for one month postpartum. Using a convergent mixed method design, surveys and interviews assessed changes in psychosocial factors and smoking status through a three month follow-up.Results: Participants reported satisfaction with TxT2Commit, rating text messages as helpful, understandable, supportive, and not bothersome. However, a majority of women (n=28, 65.1%) relapsed by three months. Participants who stayed smoke free (i.e., non-relapsers) reported significantly less temptation to smoke at one and three months postpartum compared to relapsers (ps<.01). While relapsers had significantly less temptation at one month compared to baseline, temptation increased by three months (p<.01). Consistent with the quantitative results, qualitative interviews identified informational and coping needs, with continued temptation throughout the three months. Non-relapsers were able to manage temptation and reported greater support.Conclusions for Practice: TxT2Commit demonstrates preliminary feasibility and acceptability among urban, underserved postpartum women. However, most participants relapsed by three

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Predictors of Postpartum Return to Smoking: A Systematic Review

Cited by 59 publications

References 65 publications

Smoking Behavior of Women Before, During, and after Pregnancy: Indicators of Smoking, Quitting, and Relapse

Smoking Behavior of Women Before, During, and after Pregnancy: Indicators of Smoking, Quitting, and Relapse

A systematic review of behaviour change techniques within interventions to prevent return to smoking postpartum

Persistent Barriers to Smoking Cessation Among Urban, Underserved Women: A Feasibility Study of Tailored Barriers Text Messages

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