Specifying evidence-based behavior change techniques to aid smoking cessation in pregnancy.
BACKGROUND
Behavioral support aids smoking cessation in pregnancy. However, it remains unclear which component behavior change techniques (BCTs) contribute to effectiveness or the extent to which these are applied in practice. This study aimed to examine (a) which BCTs were included in effective behavioral support interventions for pregnant smokers (b) the prevalence of use of these BCTs by the English Stop Smoking Services (SSSs).


METHODS
From a Cochrane review of smoking cessation behavioral support in pregnancy, 7 interventions were identified as effective in that they increased the odds of cessation by at least 50%, and differences between intervention and control conditions were statistically significant. BCTs in each intervention were identified using an established taxonomy of BCTs. Thirteen treatment manuals from SSSs were coded for inclusion of BCTs.


RESULTS
Thirty-seven BCTs were identified across trials of behavioral support for pregnant smokers, with an average of 8 BCTs, and a range of 6-34 BCTs, per intervention. Eleven BCTs were present in at least 2 effective interventions (e.g., facilitate goal setting [n = 6], advise on social support [n = 2], action planning [n = 5], provide rewards contingent on successfully stopping smoking [n = 4]). Only 15.4% of treatment manuals from SSSs contained all 11 BCTs; 53.8% contained at least 6 of them.


CONCLUSIONS
While BCTs associated with effective interventions can be identified from systematically reviewed literature, English SSSs appear to use only a limited proportion of these in practice.
National Health Service Centre for Smoking Cessation and Training, University College London, 441a, 1-19 Torrington Place, London WC1E 7HB, UK. Fabi.lorencatto@ncsct.co.uk
Fabiana
F
Lorencatto
Robert
R
West
Susan
S
Michie
D000328:Adult; D001521:Behavior Therapy / Q000458:organization & administration*; D016208:Databases, Factual; D019317:Evidence-Based Medicine; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D008370:Manuals as Topic; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D016540:Smoking Cessation / Q000379:methods*; D016387:Women's Health; D055815:Young Adult