Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH8 9YL, UK.
Int J Environ Res Public Health. 2019 Jun 3;16(11):1968. doi: 10.3390/ijerph16111968.
Relapse to tobacco smoking for pregnant women who quit is a major public health problem. Evidence-based approaches to intervention are urgently required. This study aimed to develop an intervention to be integrated into existing healthcare. A mixed methods approach included a theory-driven systematic review identifying promising behaviour change techniques for targeting smoking relapse prevention, and qualitative focus groups and interviews with women (ex-smokers who had remained quit and those who had relapsed), their partners and healthcare professionals ( = 74). A final stage recruited ten women to refine and initially test a prototype intervention. Our qualitative analysis suggests a lack, but need for, relapse prevention support. This should be initiated by a trusted 'credible source'. For many women this would be a midwife or a health visitor. Support needs to be tailored to individual needs, including positive praise/reward, novel digital and electronic support and partner or social support. Advice and support to use e cigarettes or nicotine replacement therapy for relapse prevention was important for some women, but others remained cautious. The resulting prototype complex intervention includes face-to-face support reiterated throughout the postpartum period, tailored digital and self-help support and novel elements such as gifts and nicotine replacement therapy (NRT).
对于已经戒烟的孕妇来说，复吸烟草是一个主要的公共卫生问题。迫切需要基于证据的干预措施。本研究旨在开发一种可以整合到现有医疗保健中的干预措施。混合方法包括基于理论的系统综述，确定针对吸烟复发预防的有前途的行为改变技术，以及对女性（已戒烟且未复发的女性、已复发的女性）、她们的伴侣和医疗保健专业人员进行的焦点小组和访谈（=74）。最后阶段招募了 10 名女性，以完善和初步测试原型干预措施。我们的定性分析表明，缺乏但需要预防复发的支持。这应该由一个可信赖的“可信来源”开始。对于许多女性来说，这将是一位助产士或一名家庭访视员。支持需要针对个人需求进行定制，包括积极的表扬/奖励、新颖的数字和电子支持以及伴侣或社会支持。对于一些女性来说，使用电子烟或尼古丁替代疗法来预防复发的建议和支持很重要，但也有一些女性仍持谨慎态度。由此产生的原型综合干预措施包括整个产后期间反复进行的面对面支持、定制的数字和自助支持以及新颖元素，如礼物和尼古丁替代疗法（NRT）。
