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An Exploration of the Process of Abstaining from Smoking and Preventing Relapse to Smoking in the Context of Transitioning to Motherhood

Bare, Susan Elizabeth (2022) An Exploration of the Process of Abstaining from Smoking and Preventing Relapse to Smoking in the Context of Transitioning to Motherhood. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Perinatal tobacco use impacts multiple individuals, the pregnant person, the fetus / newborn, and the newly developing family. Continued abstinence into the postpartum period is not a guarantee after successful cessation during pregnancy. Conservatively, the rate of postpartum relapse to smoking by the time the child reaches one-year-old is 50%. This dissertation explores tobacco decision-making in the context of transitioning to motherhood. The four stages of this transition begin in pregnancy (stage 1- preparing for maternal role) and continue into the first four months of the postpartum period (stage 2 – establishing maternal identity, stage 3 – moving toward a new normal, and stage 4 – achievement of maternal identity). Six postpartum women were interviewed for the study. Qualitative description was used to examine their experiences of abstaining from smoking during pregnancy and preventing relapse to smoking in the postpartum period. Discovered themes (40) were clustered into four categories – Motivations for Cessation and Abstinence, Processes for Cessation and Abstinence, Cycles of Abstinence and Relapse, and Considerations Regarding Use of Tobacco. Themes revealing tobacco decision-making were mapped to the stages of the transition to motherhood. Women who quit smoking for the sake of the fetus / newborn, and later recognized the benefits of cessation for self, were all successful in remaining abstinent from smoking in the postpartum period. Women who experienced any relapse in the postpartum period reported unique justifications for their perinatal smoking – personal benefits of tobacco to relieve depression and misguided beliefs about their ability to shield the newborn from harmful tobacco smoke in the environment. Moving forward, misconceptions about perinatal smoking should be corrected to support decision-making and antecedents associated with relapse should be discussed during the childbearing cycle. The ability to remain abstinent may parallel progression through the stages of becoming a mother. Thus, the stages of the transition to motherhood may be a useful framework for understanding the challenges of maintaining smoking abstinence following childbirth.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Bare, Susan Elizabethseb110@pitt.eduseb1100000-0003-3348-6978
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairDeVito Dabbs, Annetteajdst42@pitt.eduajdst42
Committee MemberAlbrecht, Susan Asaa01@pitt.edusaa01
Committee MemberBraxter, Bettybjbst32@pitt.edubjbst32
Committee MemberLevine, Michele Dlevinem@upmc.edulevinem
Date: 15 December 2022
Date Type: Publication
Defense Date: 7 December 2022
Approval Date: 15 December 2022
Submission Date: 14 December 2022
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 150
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: post-birth smoking behaviors
Date Deposited: 15 Dec 2022 20:27
Last Modified: 15 Dec 2022 20:27


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