Purpose: To understand the experiences and processes of smoking cessation, maintenance, and
relapse for pregnant and postpartum adolescents, whose perspectives and needs might be
different from other age groups.
Methods: We conducted in-depth semistructured interviews with 52 pregnant and postpartum
adolescents using tools of grounded theory analysis.
Results: Spontaneous smoking cessation during pregnancy was reported by most participants. This
was generally explained as resulting from knowledge about the harmful effects of tobacco on the
fetus, intense emotional reactions to this knowledge, or unpleasant tobacco- and pregnancyrelated physical symptoms. Relapses were common, however. Most participants experienced
guilt when they relapsed during pregnancy. Postpartum relapse was less fraught, as many participants no longer considered their smoking to negatively affect their infants. This was found even
among adolescents who were breastfeeding. Participants who did maintain cessation postpartum
typically reported support from smoke-free families and environments.
Conclusions: The results of this study suggest a constellation of protective factors that contribute
to smoking cessation and maintenance during and after pregnancy, as well as risk factors that
contribute to temporary or permanent relapses. These results can inform future research and interventions on tobacco prevention among pregnant and postpartum adolescents. Several promising strategies for intervention development are discussed.
Purpose: To understand the experiences and processes of smoking cessation, maintenance, andrelapse for pregnant and postpartum adolescents, whose perspectives and needs might bedifferent from other age groups.Methods: We conducted in-depth semistructured interviews with 52 pregnant and postpartumadolescents using tools of grounded theory analysis.Results: Spontaneous smoking cessation during pregnancy was reported by most participants. Thiswas generally explained as resulting from knowledge about the harmful effects of tobacco on thefetus, intense emotional reactions to this knowledge, or unpleasant tobacco- and pregnancyrelated physical symptoms. Relapses were common, however. Most participants experiencedguilt when they relapsed during pregnancy. Postpartum relapse was less fraught, as many participants no longer considered their smoking to negatively affect their infants. This was found evenamong adolescents who were breastfeeding. Participants who did maintain cessation postpartumtypically reported support from smoke-free families and environments.Conclusions: The results of this study suggest a constellation of protective factors that contributeto smoking cessation and maintenance during and after pregnancy, as well as risk factors thatcontribute to temporary or permanent relapses. These results can inform future research and interventions on tobacco prevention among pregnant and postpartum adolescents. Several promising strategies for intervention development are discussed.
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