Pregnant Māori Smokers’ Perception of Cessation Support and How It Can Be More Helpful

This study aimed to investigate the perception of smoking cessation services and products by pregnant Maori (New Zealand's Indigenous people) smokers and identify how these can be improved. Semi-structured face-to-face interviews were conducted with 60 pregnant Maori smokers. Most of the women (82%) had been advised to stop smoking, but few (21%) felt influenced by the advice. In addition, the women in this study felt that health provider support needed to be more encouraging, understanding and more readily available. Many (78%) had come across smokefree pamphlets, but few had read them. Only four women had been given a booklet specifically aimed at pregnant Maori women. Several women thought that the promotion of smokefree pregnancies needed to be aimed at the whole whanau (extended family). The main conclusions were that motivation to quit could be enhanced by delivery of a clear, consistent and repeated message from multiple sources, backed up with effective, supportive and encouraging services and education resources about risks and smoking cessation options. Primary health care interventions delivering a range of services need to be flexible - for example, by visiting pregnant women in their home - and need to target the whole expectant whanau, instead of focusing on pregnant women in isolation.

[1]  P. Buchan Cigarette smoking in pregnancy and fetal hyperviscosity. , 1983, British medical journal.

[2]  T. Blakely,et al.  Could mainstream anti‐smoking programs increase inequalities in tobacco use? New Zealand data from 1981‐96 , 2005, Australian and New Zealand journal of public health.

[3]  K. Watts,et al.  Exploring the views of women on using nicotine replacement therapy in pregnancy. , 2010, Midwifery.

[4]  A. Doherty,et al.  Pregnant women's perception of the implementation of smoking cessation advice , 2002 .

[5]  M. Wakefield,et al.  Cognitive and Social Influences on Smoking Behaviour During Pregnancy , 1991, The Australian & New Zealand journal of obstetrics & gynaecology.

[6]  R. Kirby,et al.  Prenatal tobacco use and risk of stillbirth: a case-control and bidirectional case-crossover study. , 2008, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[7]  P. Nafstad,et al.  Effects of pre- and postnatal exposure to parental smoking on early childhood respiratory health. , 2007, American journal of epidemiology.

[8]  M. Glover The effectiveness of a Maori Noho Marae smoking cessation intervention : utilising a kaupapa Maori methodology. , 2000 .

[9]  L. Horwood,et al.  Very low birthweight and asthma by age seven years in a national cohort , 2000, Pediatric pulmonology.

[10]  David R. Thomas,et al.  A General Inductive Approach for Analyzing Qualitative Evaluation Data , 2006 .

[11]  S. Redman,et al.  Predictors of smoking in pregnancy and attitudes and knowledge of risks of pregnant smokers. , 1997, Drug and alcohol review.

[12]  K. Watts,et al.  Women's use of nicotine replacement therapy in pregnancy-a structured review of the literature. , 2010, Midwifery.

[13]  S. Pullon,et al.  Factors that influence changes in smoking behaviour during pregnancy. , 2003, The New Zealand medical journal.

[14]  M. Grigg,et al.  Response to an indigenous smoking cessation media campaign – It's about whānau , 2008, Australian and New Zealand journal of public health.

[15]  B. Brown,et al.  Cigarette smoking during pregnancy and the occurrence of spontaneous abortion and congenital abnormality. , 1978, American journal of epidemiology.

[16]  E. Draper,et al.  A qualitative study of smoking during pregnancy , 2001 .

[17]  M. Glover,et al.  Why Māori women continue to smoke while pregnant. , 2011, The New Zealand medical journal.

[18]  P. Mullen,et al.  Relapse prevention among women who stop smoking early in pregnancy: a randomized clinical trial of a self-help intervention. , 1995, American journal of preventive medicine.

[19]  M. Cropley,et al.  Exploring the barriers of quitting smoking during pregnancy: a systematic review of qualitative studies. , 2010, Women and birth : journal of the Australian College of Midwives.

[20]  E. Gritz,et al.  Gender Differences in Smoking Cessation: Where? When? Who? Why? , 1995 .

[21]  C Abraham,et al.  Effective approaches to persuading pregnant women to quit smoking: a meta-analysis of intervention evaluation studies. , 2001, British journal of health psychology.

[22]  V. Quinn,et al.  Spontaneous quitting: self-initiated smoking cessation in early pregnancy. , 2004, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[23]  A. Dobson,et al.  Cigarette smoking, menstrual symptoms and miscarriage among young women , 2000, Australian and New Zealand journal of public health.

[24]  E. Waters,et al.  Smoking cessation programmes in pregnancy: Systematically addressing development, implementation, women's concerns and effectiveness , 2001 .

[25]  S. Pullon,et al.  Smoking cessation in New Zealand: education and resources for use by midwives for women who smoke during pregnancy. , 2003, Health promotion international.

[26]  Torgny Ottosson,et al.  Making sense of the challenge of smoking cessation during pregnancy: a phenomenographic approach. , 2005, Health education research.

[27]  A. Hofman,et al.  Maternal smoking and fetal growth characteristics in different periods of pregnancy: the generation R study. , 2007, American journal of epidemiology.