title: Naturalistic changes in the readiness of postpartum women to quit smoking.
abstract: BACKGROUND
  This study involves a long-term examination of the natural behavioral changes in postpartum women undergoing smoking cessation. The analysis was based on the readiness to quit smoking as assessed using the Transtheoretical Model of intentional behavioral change. This is a secondary data analysis of a randomized controlled trial.
  
  
  METHODS
  Between May 2002 and March 2003, all women in the maternity wards of six hospitals in the German state of Mecklenburg-West Pomerania were screened for smoking before or during pregnancy. Of the women who answered in the affirmative, 871 (77%) participated in the study.We utilized a questionnaire to classify 345 women into stages of progress regarding their motivation to change their smoking behavior 4–6 weeks postpartum (T0). Participants were followed-up after 6 (T1), 12 (T2), and 18 months(T3). In addition to the descriptive analysis, latent transition analysis was applied as a statistical method to test models of patterns of change and to evaluate transitions in the stages of change over time.
  
  
  RESULTS
  During the time interval between consecutive follow-up surveys, 59.1% (T0/T1), 72.3% (T1/T2), and 67.9% (T2/T3) of women remained at the same stage of motivation to change. Most relapses into earlier stages occurred 6 months postpartum (T1) (31.5% of the stage transition). The patterns of change across the first three time points were best described by a model that includes stability, one-stage progressions,and one-to-four-stage regressions.
  
  
  CONCLUSIONS
  Readiness to quit smoking in study participants did not substantially change over the span of 18 months postpartum.
authors.affiliation: Ernst-Moritz-Arndt-University Greifswald, Institute of Epidemiology and Social Medicine, Walther-Rathenau Str. 48, D-17487 Greifswald, Germany. grit.haendel@gmx.de
authors.forename: G
authors.initials: G
authors.lastname: Händel
authors.forename: W
authors.initials: W
authors.lastname: Hannöver
authors.forename: K
authors.initials: K
authors.lastname: Röske
authors.forename: J R
authors.initials: JR
authors.lastname: Thyrian
authors.forename: H J
authors.initials: HJ
authors.lastname: Rumpf
authors.forename: U
authors.initials: U
authors.lastname: John
authors.forename: U
authors.initials: U
authors.lastname: Hapke
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009042:Motivation; D049590:Postpartum Period; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D016540:Smoking Cessation / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult