Implementing E-Cigarettes as an Alternate Smoking Cessation Tool during Pregnancy: A Process Evaluation at Two UK Sites
Abstract
:1. Background
2. Methods
2.1. Study Design
2.2. Context
2.3. Participant Selection: Sampling
2.4. Setting
2.5. Data Collection
2.6. Research Team and Reflexivity
2.7. Data Analysis
3. Results
3.1. Quantitative Findings
3.2. Qualitative Findings
- Domain 1: Intervention characteristics
- Innovation source a
- Evidence strength and quality a
- Relative advantage
- Adaptability
- Trialability
- Complexity a
- Design quality and packaging
- Cost
- 2.
- Domain 2: Outer setting
- Needs and resources of those served by the organisation a
- Cosmopolitanism
- Peer pressure
- External policy and incentives
- 3.
- Domain 3: Inner setting
- Structural characteristics
- Networks and communication a
- Culture
- Implementation climate a
- Readiness for implementation a
- 4.
- Domain 4: Characteristics of individuals
- Knowledge and beliefs about the intervention a
- Self-efficacy a
- Individual stage of change
- Other personal attributes
- 5.
- Domain 5: Process
- Planning a
- Engaging a
- Executing a
- Reflecting and evaluating a
- Domain 1: Intervention Characteristics
- Domain 2: Outer Setting
- Domain 3: Inner Setting
- Domain 4: Characteristics of Individuals
- Domain 5: Process
4. Discussion
4.1. Summary of Findings
4.2. Strengths and Limitations
4.3. Consistency with the Literature
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- World Health Organization. Fact Sheet: Tobacco. 2020. Available online: https://www.who.int/news-room/fact-sheets/detail/tobacco (accessed on 18 July 2023).
- Reitsma, M.B.; Kendrick, P.J.; Ababneh, E.; Abbafati, C.; Abbasi-Kangevari, M.; Abdoli, A.; Abedi, A.; Abhilash, E.S.; Abila, D.B.; Aboyans, V.; et al. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: A systematic analysis from the Global Burden of Disease Study 2019. Lancet 2021, 397, 2337–2360. [Google Scholar] [CrossRef] [PubMed]
- Lange, S.; Probst, C.; Rehm, J.; Popova, S. National, regional, and global prevalence of smoking during pregnancy in the general population: A systematic review and meta-analysis. Lancet Glob. Health 2018, 6, e769–e776. [Google Scholar] [CrossRef]
- NHS Digital. Women Known to be Smokers at Time of Delivery—NHS Digital. 2023. Available online: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-women-s-smoking-status-at-time-of-delivery-england/statis-tics-on-womens-smoking-status-at-time-of-delivery-england-quarter-1-2023-24/part-2#:~:text=8.0%25%20of%20pregnant%20women%20were,6%25%20or%20less%20by%202022 (accessed on 1 December 2023).
- Shobeiri, F.; Masoumi, S.Z.; Jenabi, E. The association between maternal smoking and placenta abruption: A meta-analysis. J. Matern. Neonatal Med. 2017, 30, 1963–1967. [Google Scholar] [CrossRef]
- Heil, S.H.; Herrmann, E.S.; Badger, G.J.; Solomon, L.J.; Bernstein, I.M.; Higgins, S.T. Examining the timing of changes in cigarette smoking upon learning of pregnancy. Prev. Med. 2014, 68, 58–61. [Google Scholar] [CrossRef]
- Riaz, M.; Lewis, S.; Naughton, F.; Ussher, M. Predictors of smoking cessation during pregnancy: A systematic review and meta-analysis. Addiction 2017, 113, 610–622. [Google Scholar] [CrossRef]
- Sedgh, G.; Singh, S.; Hussain, R. Intended and Unintended Pregnancies Worldwide in 2012 and Recent Trends. Stud. Fam. Plan. 2014, 45, 301–314. [Google Scholar] [CrossRef]
- NICE. Tobacco: Preventing Uptake, Promoting Quitting and Treating Dependence. NICE Guideline 209. 2021. Available online: https://www.nice.org.uk/guidance/ng209 (accessed on 1 December 2023).
- NICE. Nicotine Replacement Therapy (NRT)|Prescribing Information|Smoking Cessation. 2023. Available online: https://cks.nice.org.uk/topics/smoking-cessation/prescribing-information/nicotine-replacement-therapy-nrt/ (accessed on 1 December 2023).
- Cooper, S.; Orton, S.; Campbell, K.A.; Ussher, M.; Coleman-Haynes, N.; Whitemore, R.; Dickinson, A.; McEwen, A.; Lewis, S.; Naughton, F.; et al. Attitudes to E-Cigarettes and Cessation Support for Pregnant Women from English Stop Smoking Services: A Mixed Methods Study. Int. J. Environ. Res. Public Health 2019, 16, 110. [Google Scholar] [CrossRef]
- NHS England. Saving Babies’ Lives a Care Bundle for Reducing Stillbirth. 2016. Available online: https://www.england.nhs.uk/wp-content/uploads/2016/03/saving-babies-lives-car-bundl.pdf (accessed on 1 December 2023).
- Claire, R.; Chamberlain, C.; Davey, M.A.; Cooper, S.E.; Berlin, I.; Leonardi-Bee, J.; Coleman, T. Pharmacological interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst. Rev. 2020, 3, CD010078. [Google Scholar] [CrossRef]
- Mersha, A.G.; Eftekhari, P.; Bovill, M.; Tollosa, D.N.; Gould, G.S. Evaluating level of adherence to nicotine replacement therapy and its impact on smoking cessation: A systematic review and meta-analysis. Arch. Public Health 2021, 79, 1–14. [Google Scholar] [CrossRef]
- McDaid, L.; Thomson, R.; Emery, J.; Coleman, T.; Cooper, S.; Phillips, L.; Bauld, L.; Naughton, F. Understanding pregnant women’s adherence-related beliefs about Nicotine Replacement Therapy for smoking cessation: A qualitative study. Br. J. Health Psychol. 2020, 26, 179–197. [Google Scholar] [CrossRef]
- Bowker, K.; Orton, S.; Cooper, S.; Naughton, F.; Whitemore, R.; Lewis, S.; Bauld, L.; Sinclair, L.; Coleman, T.; Dickinson, A.; et al. Views on and experiences of electronic cigarettes: A qualitative study of women who are pregnant or have recently given birth. BMC Pregnancy Childbirth 2018, 18, 1–10. [Google Scholar] [CrossRef]
- Taylor, L.; Claire, R.; Campbell, K.; Coleman-Haynes, T.; Leonardi-Bee, J.; Chamberlain, C.; Berlin, I.; Davey, M.; Cooper, S.; Coleman, T. Fetal safety of nicotine replacement therapy in pregnancy: Systematic review and meta-analysis. Addiction 2020, 116, 239–277. [Google Scholar] [CrossRef]
- Chamberlain, C.; O’Meara-Eaves, A.; Porter, J.; Coleman, T.; Perlen, S.M.; Thomas, J.; McKenzie, J.E. Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database Syst. Rev. 2017, 2, CD001055. [Google Scholar] [CrossRef]
- Campbell, K.; Coleman-Haynes, T.; Bowker, K.; E Cooper, S.; Connelly, S.; Coleman, T. Factors influencing the uptake and use of nicotine replacement therapy and e-cigarettes in pregnant women who smoke: A qualitative evidence synthesis. Emergencias 2020, 2020, CD013629. [Google Scholar] [CrossRef]
- McNeill, A.; Brose, L.S.; Calder, R.; Simonavicius, E.; Robson, D. Vaping in England: An Evidence Update Including Vaping for Smoking Cessation, February 2021: A Report Commissioned by Public Health England; Public Health England: London, UK, 2021. [Google Scholar]
- Hajek, P.; Phillips-Waller, A.; Przulj, D.; Pesola, F.; Smith, K.M.; Bisal, N.; Li, J.; Parrott, S.; Sasieni, P.; Dawkins, L.; et al. A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy. New Engl. J. Med. 2019, 380, 629–637. [Google Scholar] [CrossRef]
- Oncken, C.; Ricci, K.A.; Kuo, C.-L.; Dornelas, E.; Kranzler, H.R.; Sankey, H.Z. Correlates of Electronic Cigarettes Use Before and During Pregnancy. Nicotine Tob. Res. 2017, 19, 585–590. [Google Scholar] [CrossRef]
- Hajek, P.; Przulj, D.; Pesola, F.; Griffiths, C.; Walton, R.; McRobbie, H.; Coleman, T.; Lewis, S.; Whitemore, R.; Clark, M.; et al. Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: A randomized controlled trial. Nat. Med. 2022, 28, 958–964. [Google Scholar] [CrossRef]
- Bell, L.; Whelan, M.; Thomas, L.; Edwards, E.; Lycett, D.; Hayward, K.; Wilson, K.; Harrison, R.; Patel, R. Use of e-cigarettes in pregnancy: A systematic review of evidence published from 2020–2022. J. Public Health 2023, 1–14. [Google Scholar]
- Mark, K.S.; Farquhar, B.; Chisolm, M.S.; Coleman-Cowger, V.H.; Terplan, M. Knowledge, Attitudes, and Practice of Electronic Cigarette Use Among Pregnant Women. J. Addict. Med. 2015, 9, 266–272. [Google Scholar] [CrossRef]
- Siu, A.L.; Force, F.T.U.P.S.T. Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: U.S. Preventive Services Task Force Recommendation Statement. Ann. Intern. Med. 2015, 163, 622–634. [Google Scholar] [CrossRef]
- Marques, P.; Piqueras, L.; Sanz, M.-J. An updated overview of e-cigarette impact on human health. Respir. Res. 2021, 22, 1–14. [Google Scholar] [CrossRef]
- Tong, V.T.; England, L.J.; Dietz, P.M.; Asare, L.A. Smoking Patterns and Use of Cessation Interventions During Pregnancy. Am. J. Prev. Med. 2008, 35, 327–333. [Google Scholar] [CrossRef]
- Damschroder, L.J.; Aron, D.C.; Keith, R.E.; Kirsh, S.R.; Alexander, J.A.; Lowery, J.C. Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implement. Sci. 2009, 4, 50. [Google Scholar] [CrossRef]
- Skivington, K.; Matthews, L.; Simpson, S.A.; Craig, P.; Baird, J.; Blazeby, J.M.; Boyd, K.A.; Craig, N.; French, D.P.; McIntosh, E.; et al. A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. BMJ 2021, 374, n2061. [Google Scholar] [CrossRef]
- Kuipers, M.A.G.; West, R.; Beard, E.V.; Brown, J. Impact of the “Stoptober” Smoking Cessation Campaign in England from 2012 to 2017: A Quasi-experimental Repeat Cross-Sectional Study. Nicotine Tob. Res. 2020, 22, 1453–1459. [Google Scholar] [CrossRef]
- NHS. Statistics on NHS Stop Smoking Services in England—April 2020 to March 2021. 2021. Available online: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-nhs-stop-smoking-services-in-england/april-2020-to-march-2021/introduction (accessed on 1 December 2023).
- Griffiths, S.E.; Naughton, F.; Brown, K.E. Accessing specialist support to stop smoking in pregnancy: A qualitative study exploring engagement with UK-based stop smoking services. Br. J. Health Psychol. 2022, 27, 802–821. [Google Scholar] [CrossRef]
- Chiang, S.C.; Abroms, L.C.; Cleary, S.D.; Pant, I.; Doherty, L.; Krishnan, N. E-cigarettes and smoking cessation: A prospective study of a national sample of pregnant smokers. BMC Public Health 2019, 19, 1–7. [Google Scholar] [CrossRef]
- Farrimond, H.; Abraham, C. Developing E-cigarette friendly smoking cessation services in England: Staff perspectives. Harm Reduct. J. 2018, 15, 38. [Google Scholar] [CrossRef]
- Hunter, A.; Yargawa, J.; Notley, C.; Ussher, M.; Bobak, A.; Murray, R.L.; Nath, S.; Cooper, S. Healthcare Professionals’ Beliefs, Attitudes, Knowledge, and Behavior Around Vaping in Pregnancy and Postpartum: A Qualitative Study. Nicotine Tob. Res. 2021, 23, 471–478. [Google Scholar] [CrossRef]
- Greenhalgh, T.; Robert, G.; Macfarlane, F.; Bate, P.; Kyriakidou, O. Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations. Milbank Q. 2004, 82, 581–629. [Google Scholar] [CrossRef]
- Rabin, B.A.; Brownson, R.C.; Haire-Joshu, D.; Kreuter, M.W.; Weaver, N.L. A Glossary for Dissemination and Implementation Research in Health. J. Public Health Manag. Pract. 2008, 14, 117–123. [Google Scholar] [CrossRef]
- Denis, J.-L.; Hébert, Y.; Langley, A.; Lozeau, D.; Trottier, L.-H. Explaining Diffusion Patterns for Complex Health Care Innovations. Health Care Manag. Rev. 2002, 27, 60–73. [Google Scholar] [CrossRef]
- Flemming, K.; McCaughan, D.; Angus, K.; Graham, H. Qualitative systematic review: Barriers and facilitators to smoking cessation experienced by women in pregnancy and following childbirth. J. Adv. Nurs. 2014, 71, 1210–1226. [Google Scholar] [CrossRef]
- Fergie, L.; Campbell, K.A.; Coleman-Haynes, T.; Ussher, M.; Cooper, S.; Coleman, T. Stop smoking practitioner consensus on barriers and facilitators to smoking cessation in pregnancy and how to address these: A modified Delphi survey. Addict. Behav. Rep. 2019, 29, 100164. [Google Scholar] [CrossRef]
- Tobacco Advisory Group of the Royal College of Physicians. Hiding in Plain Sight: Treating Tobacco Dependency in the NHS; Royal College of Physicians: London, UK, 2018. [Google Scholar]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Lutman-White, E.; Patel, R.; Lycett, D.; Hayward, K.; Sampson, R.; Arulrajah, J.; Whelan, M. Implementing E-Cigarettes as an Alternate Smoking Cessation Tool during Pregnancy: A Process Evaluation at Two UK Sites. Int. J. Environ. Res. Public Health 2024, 21, 291. https://doi.org/10.3390/ijerph21030291
Lutman-White E, Patel R, Lycett D, Hayward K, Sampson R, Arulrajah J, Whelan M. Implementing E-Cigarettes as an Alternate Smoking Cessation Tool during Pregnancy: A Process Evaluation at Two UK Sites. International Journal of Environmental Research and Public Health. 2024; 21(3):291. https://doi.org/10.3390/ijerph21030291
Chicago/Turabian StyleLutman-White, Eleanor, Riya Patel, Deborah Lycett, Kelly Hayward, Ruth Sampson, Janani Arulrajah, and Maxine Whelan. 2024. "Implementing E-Cigarettes as an Alternate Smoking Cessation Tool during Pregnancy: A Process Evaluation at Two UK Sites" International Journal of Environmental Research and Public Health 21, no. 3: 291. https://doi.org/10.3390/ijerph21030291