Effectiveness of the Secondhand Smoke Self-Prevention Program of Pregnant Women with Smoking Family Members

Abstract

Pregnant women with smoking family members are at risk of exposure to secondhand smoke, which has negative effects on pregnancy for both the mother and the fetus. Therefore, self-prevention behavior of pregnant women from exposure to secondhand smoke is important. This mixed methods study employed a combination of qualitative and quantitative approaches to explore the situation and needs of pregnant women to protect themselves from exposure to secondhand smoke and to examine the effectiveness of the secondhand smoke self-prevention program of pregnant women with smoking family members. The qualitative sample consisted of 9 antenatal care staffs, 17 pregnant women, and 14 smoking family members. Qualitative data were collected using a structured interview and analyzed using thematic analysis. The quantitative study was a randomized controlled trial. The sample consisted of 98 pregnant women with smoking family members. They were randomly assigned to an experimental arm and a control arm, with 49 participants in each arm. Quantitative data were collected using questionnaires on knowledge about secondhand smoke, self-efficacy, and secondhand smoke self-prevention behavior of pregnant women with smoking family members, and urinary nicotine detection in pregnant women using the Elisa test. Data were analyzed using descriptive statistics, Chi-square test, and repeated measures ANOVA. The qualitative results revealed five themes, including unclear understanding of secondhand smoke; influences shaping perceptions related to secondhand smoke; attempt to prevent secondhand smoke exposure; barriers to prevention of secondhand smoke exposure; and needs related to prevention of secondhand smoke exposure.

The quantitative results showed that: 1. After receiving the program, the knowledge about secondhand smoke, self-efficacy and self-prevention behavior from secondhand smoke of pregnant women with smoking family members were higher than before receiving the program. 2. After receiving the program, the urinary nicotine of pregnant women was lower than before receiving the program. From the findings, it is recommended to explore the situation and needs of pregnant women, antenatal care staffs, and smoking family members in order to recognize their needs and plan activities in the program to prevent secondhand smoke that are appropriate for pregnant women. Smoking family members should be involved in the program incorporating activities to provide knowledge, and enhance their self-efficacy and skills for preventing secondhand smoke along with pregnant women.