Self-Efficacy as an Important Determinant of Quitting Among Pregnant Women Who Smoke: The ø-Pattern

Background. The transtheoretical model and a revised model of planned behavior were used to study the motives of pregnant women to quit or to continue smoking. The goal was to explore possibilities for tailored advice based on the motivational stage of pregnant women. Methods. A cross-sectional study included 103 pregnant women who smoked and 40 women who had quit during the last year. Five groups were formed: precontemplators, contemplators, actors, maintainers, and relapsers. Attitudes, social influences, self-efficacy, intention, and behavior were measured. Results. Precontemplators had a more negative attitude toward quitting than the other groups. Actors encountered more positive social influences for quitting. Actors and maintainers had greater self-efficacy than precontemplators and contemplators. Maintainers had greater self-efficacy than actors. Conclusion. Health education for pregnant women who smoke can be tailored toward their motivational stage. Precontemplators need information on the consequences of smoking and quitting for themselves and their baby to create a positive attitude. Contemplators and relapsers need information on coping with barriers that prevent them from quitting, in order to create greater self-efficacy. Post-delivery relapse prevention strategies are needed.