Ripley-Moffitt Carol E, Goldstein Adam O, Fang Wei Li, Butzen Anne Y, Walker Sheneika, Lohr Jacob A
School of Medicine, Department of Family Medicine, University of North Carolina, Chapel Hill, NC 27599, USA.
Nicotine Tob Res. 2008 Aug;10(8):1355-64. doi: 10.1080/14622200802238936.
This qualitative study explores smoking cessation during pregnancy and the factors that contribute to remaining smoke-free and relapsing. Ninety-four women attending prenatal clinics in central North Carolina who had quit smoking before 30 weeks gestation were enrolled in an observational study that included a face-to-face interview at 4 months postpartum. Results were analyzed for common themes in the two groups: those who remained smoke-free and those who had relapsed. Fetal health motivated pregnant women to quit smoking, while stress, socializing with smokers, cravings, and easy access to cigarettes tempted women to smoke. Women who remained smoke-free postpartum overcame temptations by continuing to acknowledge the health benefits of not smoking and having a strong internal belief system, significant social support, negative experiences with renewed exposure to cigarettes, and concrete strategies for dealing with temptations. For women who relapsed postpartum, factors having the greatest influence on relapse included easy access to cigarettes, lack of social and financial support, insufficient resources for coping with the challenges of childrearing, physical addiction, reliance on cigarettes as a primary form of stress management, and feelings of regret, shame, or low self-esteem. Recommendations for relapse prevention include assessing women who quit during pregnancy for low or high risk of relapse and offering comprehensive interventions and case management for those at higher risk to address the physical, mental, behavioral, and social contexts leading to relapse.
这项定性研究探讨了孕期戒烟以及促成保持戒烟状态和复吸的因素。在北卡罗来纳州中部产前诊所就诊、在妊娠30周前已戒烟的94名女性被纳入一项观察性研究，该研究包括在产后4个月进行的面对面访谈。对两组（保持戒烟状态的女性和复吸的女性）的共同主题进行了结果分析。胎儿健康促使孕妇戒烟，而压力、与吸烟者交往、烟瘾以及容易获得香烟则诱使女性吸烟。产后保持戒烟状态的女性通过持续认识到不吸烟对健康的益处、拥有强大的内在信念体系、获得重要的社会支持、重新接触香烟后的负面经历以及应对诱惑的具体策略来克服诱惑。对于产后复吸的女性，对复吸影响最大的因素包括容易获得香烟、缺乏社会和经济支持、应对育儿挑战的资源不足、身体成瘾、依赖香烟作为主要的压力管理方式以及后悔、羞耻或自卑的感觉。预防复吸的建议包括评估孕期戒烟女性的复吸低风险或高风险，并为高风险女性提供全面干预和个案管理，以解决导致复吸的身体、心理、行为和社会背景问题。
