A number of women continue to smoke in pregnancy despite the associated risks to their health and that of their unborn child. Little is known about their attitudes towards the smoking cessation support which is available to them and this thesis used a Theory of Planned Behaviour (TPB) approach to investigate this further. Study One was a qualitative investigation designed to elicit pregnant women's views about NHS Stop Smoking Services and Nicotine Replacement Therapy (NRT). Interviews were conducted with 18 pregnant smokers, recent quitters and new mothers who smoked in pregnancy, and 18 health professionals working in smoking cessation services. A number of behavioural, normative and control beliefs were generated with respect to these behaviours. As there is evidence for inconsistent smoking cessation advice giving in pregnancy and a lack of confidence amongst health professionals in this area, a theory-based resource to facilitate the communication of smoking cessation information in pregnancy was developed in Study Two and tested in an exploratory randomised controlled trial. The 22 second year medical students who viewed the theory-based resource in preparation for a mock interview were not significantly better at eliciting the salient smoking cessation beliefs of the simulated patient (mean score 8.41) than the 18 second year medical students who received a standard information resource (mean score 7.67). However, the resource showed potential to facilitate the delivery of a more patient centred interview and is worthy of further testing. The themes generated in Study One were used to inform the development of a TPB questionnaire to predict NRT use in pregnancy (NRTP-LF) in Study Three. This questionnaire was completed by 100 pregnant smokers who were recruited from antenatal clinics and Stop Smoking Services. The NRTP-LF significantly predicted intention to use NRT in pregnancy, explaining 41.1% of the variance in the outcome variable, justifying the creation of a short form version of it (NRTPSF). In Study Four, the NRTP-SF was tested on a further sample of 204 pregnant smokers recruited from antenatal clinics and Stop Smoking Services and was also shown to have predictive validity with respect to intention to use NRT in pregnancy. It also significantly predicted interest in participation in a trial testing the efficacy and safety of NRT use in pregnancy. It is envisaged that the theory-based communication resource and the NRTP-SF could have practical utility in health care settings and the potential to increase smoking cessation service use and quit rates in pregnancy.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:523508 |
| Date | January 2010 |
| Creators | Taylor, John Adam |
| Publisher | University of Nottingham |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://eprints.nottingham.ac.uk/11938/ |
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