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Kroll-Desrosiers A, Holzhauer CG, Russo L, DeRycke EC, Kinney RL, Bastian LA, Mattocks KM. Factors Associated With Quitting Smoking During Pregnancy Among Women Veterans. Womens Health Issues 2021; 31:408-413. [PMID: 34049763 DOI: 10.1016/j.whi.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Little is known about the rates of smoking among pregnant veterans. Our objective was to examine rates of smoking during pregnancy and factors associated with quitting smoking during pregnancy. METHODS We used data from a cohort study of pregnant veterans from 15 Veterans Health Administration facilities nationwide. Veterans who reported smoking during pregnancy were included in this analysis. Poisson regression models were used to estimate the relative risk (RR) of quitting smoking during pregnancy. RESULTS Overall, 133 veterans reported smoking during pregnancy. Among this group of women who smoked, the average age was 31.6 years, 20% were Black, and 14% were Hispanic/Latino. More than one-half of women (65%) who reported smoking at the start of pregnancy quit smoking during pregnancy. Multivariable models, adjusted for history of deployment and age, indicated that prenatal care initiation at 12 or fewer weeks compared with more than 13 weeks (relative risk [RR], 2.06; 95% confidence interval [CI], 1.18-3.58), living without household smokers compared with any household smokers (RR, 1.58; 95% CI, 1.14-2.17), and first pregnancy (RR, 1.51; 95% CI, 1.17-1.95) were significant predictors of quitting versus persistent smoking during pregnancy. CONCLUSIONS Women veterans who quit smoking may be different than those who continue to smoke during pregnancy. Establishing prenatal care early in pregnancy, which likely includes counseling about smoking cessation, seems to be an important factor in quitting. Those for whom it is not a first pregnancy and who live with other smokers may especially benefit from such counseling.
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Affiliation(s)
- Aimee Kroll-Desrosiers
- Research and Development, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
| | - Cathryn Glanton Holzhauer
- Research and Development, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Lindsey Russo
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Eric C DeRycke
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Rebecca L Kinney
- Research and Development, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts
| | - Lori A Bastian
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut; Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Kristin M Mattocks
- Research and Development, VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
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Jaber R, Blaga OM, Dascal MD, Meghea CI. Perceived safety of smoking a few cigarettes during pregnancy and provider advice in a sample of pregnant smokers from Romania. Addiction 2021; 116:394-399. [PMID: 33475224 PMCID: PMC7839124 DOI: 10.1111/add.15201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/19/2020] [Accepted: 07/21/2020] [Indexed: 11/27/2022]
Abstract
AIMS To assess the prevalence of the perceived safety of smoking a few (generally fewer than five per day) cigarettes during pregnancy and identify associated factors in a sample of pregnant smokers in Romania, a middle-income country. DESIGN AND SETTING Cross-sectional design with a convenience sample using a polled data set collected between 2016 and 2019 in the formative and baseline phases of the Quit Together randomized control trial (RCT) in Romania. Data were collected using a structured questionnaire administered by research assistants in clinics in the formative phase and self-administered through the study website at the RCT baseline. PARTICIPANTS A total of 217 pregnant smokers (mean age = 28.5 ± 5.8) enrolled in the formative and RCT phases of the research project. MEASUREMENTS The main outcome was the perceived safety of smoking a few cigarettes during pregnancy (generally fewer than five per day). Covariates included the health-care providers' advice towards smoking tobacco cigarettes during pregnancy, socio-demographics, the presence of depression and anxiety symptoms and level of nicotine dependence. FINDINGS More than 35% of participants agreed that smoking a few cigarettes during pregnancy was safe for them and their baby. The perceived safety of smoking a few cigarettes during pregnancy was significantly associated with being told by health-care providers that it is acceptable to continue to smoke cigarettes in small amounts [odds ratio (OR) = 3.08; 95% CI = 1.35-6.99; P < 0.01], perceived harm reduction of smoking light cigarettes (OR = 2.67; 95% CI = 1.19-5.97; P = 0.02) and moderate to severe depression and anxiety score (OR = 0.34; 95% CI = 0.13-0.84; P = 0.02). CONCLUSIONS More than one-third of pregnant Romanian women appear to believe that smoking 'a few' cigarettes during pregnancy is safe for them and their fetuses. Those who are told by their health-care providers that it is acceptable to smoke in small amounts during pregnancy have higher odds of perceiving smoking 'a few' cigarettes during pregnancy as safe compared with other pregnant Romanian women.
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Affiliation(s)
- Rana Jaber
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, A627 East Fee Hall, USA
| | - Oana M. Blaga
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University Cluj-Napoca, Romania,Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University Cluj-Napoca, Romania
| | - Marina D. Dascal
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University Cluj-Napoca, Romania,Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University Cluj-Napoca, Romania
| | - Cristian I. Meghea
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, A627 East Fee Hall, USA,Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University Cluj-Napoca, Romania,Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University Cluj-Napoca, Romania
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Using Behavioral Nudges to Engage Pregnant Women in a Smoking Cessation Trial: An Online Field Quasi-Experiment. Healthcare (Basel) 2020; 8:healthcare8040531. [PMID: 33276634 PMCID: PMC7761597 DOI: 10.3390/healthcare8040531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 11/17/2022] Open
Abstract
Evidence shows that behavioral nudges could be used to enhance enrollment rates in randomized controlled trials (RCTs) by addressing enrollment barriers, but research on this topic is limited. We conducted an online field quasi-experiment with separate pretest (October 2017-January 2018) and posttest (February-May 2018) samples designed to examine the use of behavioral nudges to engage pregnant smokers in a couple-focused smoking cessation RCT relying on online enrollment through paid Facebook ads and a dedicated website, by reporting aggregate Facebook ads and Google Analytics data. The Facebook ads pretest conversion rate of 1.6% doubled and reached 3.41% in the posttest period. The pretest eligibility assessment rate decreased from 10.3% to 6.46%, but registered a relative increase of approximately 50% in the posttest period, as opposed to the pretest. The number of women who signed the informed consent in the posttest period has increased with 63%, from a proportion of 8.54% in the pretest to 11.73% in the posttest period. These findings might lend support to integrating behavioral nudges in the recruitment and enrollment materials of RCTs to boost enrollment.
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Dascăl MD, Meghea CI, Blaga OM. A Cross-Section Study of Relationship Characteristics and Smoking Cessation During Pregnancy in a Sample of Romanian Pregnant Women. Matern Child Health J 2020; 24:1113-1120. [PMID: 32048171 DOI: 10.1007/s10995-020-02898-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Partner support and relationship characteristics may be important factors in effective couple-based pregnancy smoking cessation programs. Research is needed to investigate the links between couple relationship characteristics and maternal smoking cessation to inform the development of such interventions. METHODS This paper relies on cross-section data collected during the formative phase in the development of an ongoing couple-focused pregnancy tobacco cessation trial. Data (n = 143 pregnant women) were collected from two large public and one private obstetrics and gynecology clinics located in Cluj-Napoca, Romania. Multiple logistic regression was used to identify correlates of smoking cessation during pregnancy. RESULTS Higher education was a significant correlate of smoking cessation during pregnancy. Women with a college degree or more had higher odds to quit smoking during pregnancy in comparison to their counterparts who graduated high school or less (OR 14.3, 95% CI 2.75-74.28). In addition, women with increased positive partner interactions related to their smoking cessation efforts correlated with higher odds of quitting smoking during pregnancy (OR 1.48, 95% CI 1.15-1.91). DISCUSSION While pregnancy tobacco cessation interventions with partner support do exist, most were not successful and did not focus on couple-related concepts such as partner interactions, dyadic coping, and dyadic efficacy. The findings of the study are important because they bring new insights regarding the potential role of relationship characteristics to inform future cessation programs focused on pregnant smokers and their life partners.
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Affiliation(s)
- Marina Denisa Dascăl
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Cristian Ioan Meghea
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, A627 East Fee Hall, East Landing, USA
| | - Oana Maria Blaga
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania. .,Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.
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Kocataş S, Güler N, Sezer RE. Factors Affecting Smoking Behaviors and Smoking Prevalence in Pregnancy and Postpartum Period of Women. Florence Nightingale Hemsire Derg 2020; 28:230-242. [PMID: 34263202 PMCID: PMC8152163 DOI: 10.5152/fnjn.2020.18031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 09/12/2019] [Indexed: 11/22/2022] Open
Abstract
Aim This study aimed to determine the factors affecting smoking behaviors and smoking prevalence among women during pregnancy and postpartum period. Method This cross-sectional study was conducted between May 2012 and October 2012 on a sample of 640 women who had children aged between one and three years and who enrolled in any one of the 23 family health centers located in the province of Sivas in Turkey. The data were collected through the questionnaires created by the researchers by interviewing the participants face to face in own homes. The data obtained were analyzed using the Statistical Package for the Social Sciences Statistics 15.0 (SPSS Inc.; Chicago, IL, USA) package program and evaluated using number, percentage distribution, chi square test, logistic regression analysis and Kaplan-Meier survival analysis. Results Smoking prevalence was found to be 8% during pregnancy and 15.6% in the postpartum period. It was determined that 17.2% of the women smoked before their last pregnancy (n=110), more than half of the smokers quit smoking during pregnancy (n=59), and 46.4% of them continued to smoke during pregnancy. It was determined that 79.7% of the participants who quit smoking during pregnancy relapsed within the first one to three years of the postpartum period, and only 20.3% continued not to smoke. The Kaplan-Meier survival analysis showed that women who breastfed quit smoking for a significantly longer time (27.6 months) compared with those who did not breastfeed (12 months). According to the logistic regression analysis, the risk of postpartum relapse among women aged 30 years or more was 10.99-fold higher than women between the ages of 19 and 29. Conclusion The rate of pre-pregnancy smokers decreased in the pregnancy and increased in the postpartum period.
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Affiliation(s)
- Semra Kocataş
- Department of Public Health Nursing, Sivas Cumhuriyet University Faculty of Health Science, Sivas, Turkey
| | - Nuran Güler
- Department of Public Health Nursing, Sivas Cumhuriyet University Faculty of Health Science, Sivas, Turkey
| | - Recep Erol Sezer
- Department of Public Health and Familiy Medicine, Yeditepe University, Faculty of Medicine, İstanbul, Turkey
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Dascal M, Rusu A, Onisor A, Blaga O, Miller M, Meghea C. An mHealth intervention to prevent postnatal smoking relapse: The RESPREMO study protocol. Tob Prev Cessat 2020; 6:24. [PMID: 32548361 PMCID: PMC7291910 DOI: 10.18332/tpc/118724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 12/21/2022]
Abstract
Up to 70% of women who quit smoking relapse after birth, usually within 3 months postpartum. The wide adoption of mobile technologies, especially smartphones, in recent years in low- and middle-income countries (LMICs) offers the possibility of low-cost, novel, and innovative mobile phone-based interventions for smoking relapse prevention. This study presents the protocol of the RESPREMO clinical trial for postnatal smoking relapse prevention for enrolled women, who recently gave birth and quit tobacco smoking before or during pregnancy, and their life partners. This work relies on data collected in two of the largest government-owned obstetrics and gynecology clinics in Cluj-Napoca, Romania. Seventy-five couples were randomized into one of three groups: a) 24 couples were allocated to the first intervention group and asked to install and use the xSmoker app; b) 26 couples were randomized to the second intervention group, who, in addition to the use of the xSmoker app, received text messages with content focused on motivation, problem solving, and dyadic efficacy; and c) 25 couples were randomized into a control group. Several measures of engagement with the xSmoker app were assessed, including duration of app use, the frequency of utilizing the tool to calculate savings from quitting, number of app-delivered challenges accepted by users, and number of app-delivered cessation and abstinence tips. If effective, RESPREMO is expected to have a sustainable impact on the prevention of postnatal relapse tobacco smoking with positive effects for both the mother and the newborn. The implications are beyond tobacco control, and relevant to the design and implementation of other mHealth behavioral interventions focused on the pregnancy and reproductive years in general.
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Affiliation(s)
- Marina Dascal
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania.,Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Andreea Rusu
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania.,Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Alexandra Onisor
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania.,Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Oana Blaga
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania.,Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Mckenzie Miller
- College of Human Medicine, Michigan State University, East Lansing, United States
| | - Cristian Meghea
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania.,Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania.,Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, United States
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Míguez MC, Pereira B, Pinto TM, Figueiredo B. Continued tobacco consumption during pregnancy and women's depression and anxiety symptoms. Int J Public Health 2019; 64:1355-1365. [PMID: 31628523 DOI: 10.1007/s00038-019-01308-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/31/2019] [Accepted: 10/05/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES This study aimed to analyse depression and anxiety symptoms changes from the first to the third trimester of pregnancy in non-smokers versus quitters versus continuous smokers, and the contribution of depression and anxiety symptoms to continued tobacco consumption during pregnancy. METHODS The sample comprises 850 Spanish pregnant women (595 non-smokers, 123 quitters, and 132 continuous smokers), assessed at the first and the third trimester of pregnancy with a questionnaire concerning socio-demographic, obstetric, and tobacco consumption information, and measures of depression and anxiety. RESULTS Continuous smokers during pregnancy showed more depression and anxiety symptoms than both non-smokers and quitters and no changes from the first trimester to the third trimester of pregnancy, while both non-smokers and quitters revealed a decrease in depression and anxiety symptoms. More anxiety symptoms at the first trimester (OR 1.03) and depression symptoms at the third trimester (OR 1.14) were associated with continued smoking during pregnancy. CONCLUSIONS Anxiety and depression symptoms need to be considered to screening for women at risk of smoking during pregnancy. Future prenatal smoking cessation interventions must take into account these variables.
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Affiliation(s)
- M Carmen Míguez
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Campus Vida, 15782, Santiago de Compostela, Spain.
| | - Beatriz Pereira
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Campus Vida, 15782, Santiago de Compostela, Spain
| | - Tiago Miguel Pinto
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Bárbara Figueiredo
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
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Meghea CI, Brinzaniuc A, Sidor A, Chereches RM, Mihu D, Iuhas CI, Stamatian F, Caracostea G, Dascal MD, Foley K, Baban A, Voice TC, Blaga OM. A couples-focused intervention for smoking cessation during pregnancy: The study protocol of the Quit Together pilot randomized controlled trial. Tob Prev Cessat 2018; 4:17. [PMID: 30906906 PMCID: PMC6430127 DOI: 10.18332/tpc/89926] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 11/24/2022]
Abstract
Tobacco smoking remains the leading global cause of preventable disease and death. Preconception and pregnancy smoking are high in Central and Eastern Europe. Quit Together is a partnership between a US university and a Romanian university, obstetrics and gynecology clinics in Romania, and other community partners in Romania. The objective of the Quit Together pilot study is to adapt, enhance and test the implementation feasibility and initial efficacy of an evidence-based pregnancy and postnatal couple intervention for smoking cessation in Romania. Quit Together builds on the Motivation and Problem Solving (MAPS) approach, enhanced by targeting the couples' smoking behavior and focusing on dyadic efficacy for smoking cessation. The study is an ongoing randomized controlled trial of 120 Romanian pregnant smokers and their partners. Participants are randomized to: 1) an intervention arm consisting, typically, of up to 8 prenatal and postnatal telephone counseling calls for the women and 4 for their partners, combining motivational strategies and problem-solving/coping skills to encourage the woman to quit smoking and the partner to support her decision; and 2) a control arm (usual care). The primary outcome is maternal biochemically verified smoking abstinence at 3 months postpartum. Quit Together has the potential to identify effective strategies to increase maternal smoking cessation during pregnancy and smoking abstinence after birth. If effective, Quit Together is expected to have a sustainable positive impact on the health of the child, mother and partner, and potentially reduced health system costs.
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Affiliation(s)
- Cristian I. Meghea
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Michigan, USA
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Alexandra Brinzaniuc
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Alexandra Sidor
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Razvan M. Chereches
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Dan Mihu
- Iuliu Hatieganu University of Medicine and Pharmacy, Department of Obstetrics and Gynaecology Dominic Stanca Clinic, Cluj-Napoca, Romania
| | - Cristian I. Iuhas
- Iuliu Hatieganu University of Medicine and Pharmacy, Department of Obstetrics and Gynaecology Dominic Stanca Clinic, Cluj-Napoca, Romania
| | - Florin Stamatian
- Iuliu Hatieganu University of Medicine and Pharmacy, Department of Obstetrics and Gynaecology Clinic I, Cluj-Napoca, Romania
| | - Gabriela Caracostea
- Iuliu Hatieganu University of Medicine and Pharmacy, Department of Obstetrics and Gynaecology Clinic I, Cluj-Napoca, Romania
| | - Marina D. Dascal
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Kristie Foley
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest University, North Carolina, USA
| | - Adriana Baban
- Department of Psychology, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Thomas C. Voice
- Department of Civil and Environmental Engineering, College of Engineering, Michigan State University, Michigan, USA
| | - Oana M. Blaga
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
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9
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Brinzaniuc A, Strilciuc A, Blaga OM, Chereches RM, Meghea CI. Smoking and quitting smoking during pregnancy: A qualitative exploration of the socio-cultural context for the development of a couple-based smoking cessation intervention in Romania. Tob Prev Cessat 2018; 4. [PMID: 30906905 PMCID: PMC6428424 DOI: 10.18332/tpc/86161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Smoking during pregnancy has negative effects on the mother and the unborn infant. Barriers to and facilitators of smoking cessation during pregnancy are context-dependent and multifaceted. This qualitative research explored pregnant women's experiences with smoking and cessation in Romania, and informed the development of a couple-focused smoking cessation intervention. METHODS Semi-structured, in-depth interviews were conducted via telephone, with 15 pregnant women who smoked during pregnancy or had quit smoking upon learning about the pregnancy or shortly before. A hybrid inductive-deductive approach to thematic analysis was used, to identify patterns in the data and explore women's narratives, in relation to smoking and smoking cessation. RESULTS Three main themes emerged from the data, which shaped the socio-cultural adaptation of the intervention to the local context: 1) Access to and mixed messages from the healthcare system that describe an inconsistent discourse from the healthcare system regarding smoking during pregnancy with some physicians not emphasizing the need for cessation, 2) Cessation as individual or team effort with variations in partner dynamics and difficulty in quitting that have important roles in perceptions about team efforts, and 3) Transition to motherhood and motivation to quit for the health of the pregnancy and infant, although in isolated cases women felt less connected with the pregnancy and such motivators. CONCLUSIONS Pregnant women in Romania face systemic, interpersonal, and individual-level barriers that can be responsively integrated in smoking cessation interventions, by culturally adapting them to the local context.
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Affiliation(s)
- Alexandra Brinzaniuc
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Andreea Strilciuc
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Oana M Blaga
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Razvan M Chereches
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Cristian I Meghea
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, USA
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10
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Meghea CI, Brinzaniuc A, Rus IA, Chereches RM, Mihu D, Iuhas CI, Stamatian F, Caracostea G, Blaga OM. Characteristics of Romanian women who enrolled in a postpartum tobacco smoking relapse prevention trial. Public Health 2017; 154:98-101. [PMID: 29220712 DOI: 10.1016/j.puhe.2017.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 09/18/2017] [Accepted: 10/23/2017] [Indexed: 11/25/2022]
Affiliation(s)
- C I Meghea
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, A134 East Fee Hall, East Lansing, MI, 48823, USA; Department of Public Health, College of Political, Administrative and Communication Sciences, Babeş-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, 400376, Romania
| | - A Brinzaniuc
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeş-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, 400376, Romania; Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeş-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, 400376, Romania
| | - I A Rus
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeş-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, 400376, Romania; Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeş-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, 400376, Romania
| | - R M Chereches
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeş-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, 400376, Romania; Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeş-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, 400376, Romania
| | - D Mihu
- Department of Obstetrics and Gynaecology, "Dominic Stanca" Clinic, 55-57 21 Decembrie 1989 Street, 400124, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca Romania
| | - C I Iuhas
- Department of Obstetrics and Gynaecology, "Dominic Stanca" Clinic, 55-57 21 Decembrie 1989 Street, 400124, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca Romania
| | - F Stamatian
- Department of Obstetrics and Gynaecology, Clinic I, 3-5 Clinicilor Street, 400006, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - G Caracostea
- Department of Obstetrics and Gynaecology, Clinic I, 3-5 Clinicilor Street, 400006, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - O M Blaga
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeş-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, 400376, Romania; Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeş-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, 400376, Romania.
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