A systematic review of behaviour change techniques within interventions to prevent return to smoking postpartum

Tracey J Brown; Wendy Hardeman; Linda Bauld; Richard Holland; Vivienne Maskrey; Felix Naughton; Sophie Orton; Michael Ussher; Caitlin Notley

doi:10.1016/j.addbeh.2018.12.031

A systematic review of behaviour change techniques within interventions to prevent return to smoking postpartum

Addict Behav. 2019 May:92:236-243. doi: 10.1016/j.addbeh.2018.12.031. Epub 2018 Dec 23.

Authors

Tracey J Brown¹, Wendy Hardeman², Linda Bauld³, Richard Holland⁴, Vivienne Maskrey⁵, Felix Naughton², Sophie Orton⁶, Michael Ussher⁷, Caitlin Notley⁵

Affiliations

¹ Norwich Medical School, University of East Anglia, Norwich, UK. Electronic address: tracey.j.brown@uea.ac.uk.
² School of Health Sciences, University of East Anglia, Norwich, UK.
³ Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
⁴ Leicester Medical School, University of Leicester, Leicester, UK.
⁵ Norwich Medical School, University of East Anglia, Norwich, UK.
⁶ Division of Primary Care, University of Nottingham, Nottingham, UK.
⁷ Population Health Research Institute, St George's, University of London, London, UK & Institute for Social Marketing, University of Stirling, Stirling, UK.

Abstract

Introduction: There is no routine support to prevent postpartum smoking relapse, due to lack of effective interventions. Previous reviews have identified behaviour change techniques (BCTs) within pregnancy cessation trials to specify which components might be incorporated into more effective interventions, but no reviews have identified BCTs for prevention of smoking relapse postpartum. We reviewed BCTs and potential delivery modes, to inform future interventions.

Methods: We searched Medline and EMBASE from January 2015-May 2017; and identified trials published before 2015 by handsearching systematic reviews. We included RCTs where: i) ≥1 intervention component aimed to maintain smoking abstinence versus a less intensive intervention; ii) participants included pregnant or postpartum smoking quitters; iii) smoking status was reported in the postpartum period. We extracted trial characteristics and used the Behaviour Change Technique Taxonomy v1 to extract BCTs. We aimed to identify 'promising' BCTs i.e. those frequently occurring and present in ≥2 trials that demonstrated long-term effectiveness (≥6 months postpartum). Data synthesis was narrative.

Results: We included 32 trials, six of which demonstrated long-term effectiveness. These six trials used self-help, mainly in conjunction with counselling, and were largely delivered remotely. We identified six BCTs as promising: 'problem solving', 'information about health consequences', 'information about social and environmental consequences', 'social support', 'reduce negative emotions' and 'instruction on how to perform a behaviour'.

Conclusions: Future interventions to prevent postpartum smoking relapse might include these six BCTs to maximise effectiveness. Tailored self-help approaches, with/without counselling, may be favourable modes of delivery of BCTs. Registration: PROSPERO CRD42018075677.

Keywords: Behaviour change techniques; Intervention; Postpartum; Pregnancy; Review; Smoking relapse.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Behavior Therapy / methods*
Counseling / methods
Exercise / psychology
Female
Humans
Postpartum Period / psychology*
Pregnancy
Problem Solving
Secondary Prevention / methods*
Smoking Cessation / methods
Smoking Cessation / psychology*
Social Support
Tobacco Smoking / prevention & control*
Tobacco Smoking / psychology*

Grants and funding

MR/P016944/1/MRC_/Medical Research Council/United Kingdom