Revista de Enfermagem e Cuidados com o Paciente

Does the Use of Motivational Text Messages and a Smoking Cessation Quitline Influence Smoking Behaviors in Pregnant Women in Tennessee?

Morehead A, Morse E and Price J

Background: Approximately 15% of women in Tennessee continue to smoke during pregnancy knowing the health risks to themselves and their unborn babies. The use of evidence based interventions is essential to assist pregnant women who smoke in their cessation attempts and in the reduction of adverse effects of smoking during pregnancy.

Objective: This scholarly project aims to determine if the use of motivational text messages and a reactive smoking cessation quitline influence smoking behaviors (motivation to quit, dependence on nicotine and the number of cigarettes smoked per day) in a group of pregnant women who smoke in Tennessee. Methods: The study sample consisted of pregnant women in Tennessee who self-reported smoking. Participants were enrolled to receive motivational text messages from Smoke-Free Mom, and were given the contact information for the Tennessee Tobacco Quitline. Baseline motivation to quit was obtained with the Motivation to Stop Scale, dependence on nicotine was measured with the Autonomy over Smoking Scale, and self-reported cigarettes smoked per day were obtained. Utilization of the interventions was assessed during the study, and post-intervention, motivation to quit score, dependence on nicotine score, and self-reported cigarettes smoked per day were obtained.

Results: 43 participants (87%) completed post-test questionnaires. 43 participants (87%) completed post-test questionnaires. Wilcoxan Signed Ranks test demonstrated an overall increase in self-reported motivation to quit, decrease in dependence, and cigarettes smoked per day. Linear regression demonstrated a correlation between utilization of the text messages and decrease in dependence, however, the effect was small. No significant relationship was found between utilization of text messages and motivation to quit or cigarettes smoked per day. This study provided inconclusive results supporting the benefit of motivational text messages and a reactive quitline in pregnant women who smoke. The Wilcoxan Signed Ranks test demonstrated an overall increase in self-reported motivation to quit, decrease in dependence, and cigarettes smoked per day. Linear regression demonstrated a correlation between utilization of the text messages and decrease in dependence, however, the effect was small. No significant relationship was found between utilization of text messages and motivation to quit or cigarettes smoked per day. This study provided inconclusive results supporting the benefit of motivational text messages and a reactive quitline in pregnant women who smoke.

Conclusion: High levels of intrinsic motivation present in pregnancy can influence changes in health behaviors irrespective of intervention. Health care providers are encouraged to assess smoking status in all pregnant patients, and to provide smoking cessation counseling to all patients who self-report as a smoker. Further studies are warranted to determine efficacy of motivational text messages and smoking cessation quitlines in pregnant women.