Stress- and Smoke Free Start of Life

This project aims to reduce smoking among pregnant women, via a personalized e-health application targeting stress and smoking in women with low socio-economic status (SES). An important element that existing smoking cessation programs are lacking, which have been mostly unsuccessful in women with low SES, is stress-coping management. Stress is a common maintaining factor among smokers, particularly for women who live in disadvantaged circumstances, and smoking is often used as a way to alleviate feelings of tension. Chronic daily stress also makes it difficult to change lifestyle habits, such as smoking. Despite the observed co-occurrence of smoking with high levels of stress among low SES pregnant women, we still lack an intervention that also supports pregnant women in learning new stress-coping skills. It is essential that a smoking cessation program, especially those targeting low SES women, also includes effective stress-coping techniques. Therefore, the e-health application will, amongst other components, consist of HRV-biofeedback training. HRV-biofeedback entails a method of paced breathing using visual feedback. It is easy to learn and maintain in daily life, and as it required little cognitive efforts we think this is a well-applicable method for our target group to learn manage their stress and smoking behavior.

This study will evaluate the effectiveness of an e-health application in reducing smoking and stress among pregnant women and the first months following childbirth. The e-health application will be compared with a control condition, consisting of a single online psycho-education module on pregnancy, stress, and smoking during pregnancy. Both groups will consist of 80 participants, who will be randomly allocated to one of the two groups. The participants will be asked to fill in a questionnaire at four different time points: pre-intervention or baseline (T0), post-intervention (8 weeks after T0; T1), two weeks after birth (T2) and three months after birth (T3). Primary outcome variables are smoking behavior and perceived stress. Secondary outcomes include maternal self-efficacy, pregnancy experience, pregnancy anxiety, birth outcomes, and infant temperament at three months of age.

We hypothesize that the intervention results in smoking cessation and stress reduction. Moreover, we expect more optimal secondary outcomes, such as birth outcomes and infant temperament for women who successfully participated in the intervention.

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e-health stop-smoking intervention