Postpartum return to smoking: identifying different groups to tailor interventions.
OBJECTIVE
(a) To describe a population-based sample of women postpartum who smoked before pregnancy on grounds of the perceived advantages and disadvantages of nonsmoking and the self-efficacy not to smoke. (b) To identify grouping characteristics that can differentiate among those women. This could lead to the development of intervention strategies that are of different efficacy depending on the cluster the woman is member of.


METHODS
A population-based sample of 317 women who had smoked at the beginning of pregnancy and who were smoke-free at the time of giving birth.


METHODS
Data about the acquisition stages of change to restart smoking, the perceived advantages of nonsmoking and the self-efficacy to remain smoke free on grounds of the Transtheoretical Model of Behavior Change was assessed. Smoking status was assessed 12 months later.


METHODS
A cluster analysis was used to identify different groups; a logistic regression was calculated to assure the external validity of the clusters identified.


RESULTS
The acquisition stages of change do not fit the situation of nonsmoking women postpartum in Germany, but four different clusters of ex-smoking women postpartum were identified on grounds of the other TTM-constructs. These are: the protected, the high risk, the premature and the ambivalent group. The clusters are associated with relapse after 12 months, none of the other variables controlled for was statistically significant.


CONCLUSIONS
The TTM contributes to a better understanding of nonsmoking women postpartum. Further studies have to replicate the clusters found and have to find whether interventions tailored to these clusters are more effective in preventing relapse than other interventions.
Thyrian
Jochen René
JR
Institute of Epidemiology and Social Medicine, Ernst-Moritz-Arndt-University of Greifswald, Walther-Rathenau-Str. 48, 17489 Greifswald, Germany. thyrian@uni-greifswald.de
Hannöver
Wolfgang
W
Röske
Kathrin
K
Rumpf
Hans-Jürgen
HJ
John
Ulrich
U
Hapke
Ulfert
U
D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D011181:Postnatal Care / Q000379:methods; D049590:Postpartum Period; D011247:Pregnancy; D012008:Recurrence; D012044:Regression Analysis; D020377:Self Efficacy; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*