A qualitative study of women's intentions to smoke following abstinence during pregnancy: Findings from the New England SCRIPT Trial

Background: Many women quit smoking for the duration of their pregnancy. However, 60% to 80% of pregnant quitters relapse during the first six months postpartum. The purpose of this study was to examine women's intentions to return to smoking postpartum following sustained abstinence during pregnancy. Methods: A purposive criterion-based sample of underserved pregnant women who participated in the N.E. SCRIPT randomized clinical trial and reported that they quit smoking during pregnancy were invited to participate in focused interviews following delivery. Qualitative 30-minute interviews were conducted with women during the postpartum period. Data were coded by one of the authors (CR) and reviewed by the first author (DP). Results: Forty-one women were interviewed and ranged in age from 15 to 40 years and 55% were Non-Hispanic White. Of the 41 women interviewed, 5 reported to relapse during pregnancy and 18 women reported to relapse following delivery. Two major factors that contributed to relapsing both during and after pregnancy included: 1) stress (due to relationships, job-related, daily living, pregnancy, new born) and 2) socializing and/or living with other smokers. Of the women who reported to remain smoke-free following delivery, major factors that contributed to continued smoking abstinence included: 1) support from family and friends, 2) living and socializing with only non-smokers or family and friends who refrain from smoking around the woman and 3) health of the baby. Conclusions: These data suggest that interventions designed to prevent postpartum smoking relapse should address social support and coping and stress reduction strategies.