Knowledge about the Deleterious Effects of Smoking and Its Relationship to Smoking Cessation among Pregnant Adolescents
Albrecht, Susan A., Higgins, Linda W., Lebow, Howard, Adolescence
Smoking cessation among pregnant adolescents remains a complex and unresolved issue. The purpose of this study was to examine adolescents' knowledge of the detrimental effects of smoking on pregnant women and fetuses and its relationship to efforts to quit smoking. The sample consisted of 71 pregnant adolescents, and a three-group randomized intervention design--Teen FreshStart (TFS), Teen FreshStart with buddy (TFSB), and usual care control (UCC)--was used. Instruments included a demographic questionnaire, a smoking history questionnaire, and an 11-item scale measuring knowledge of the effects of smoking during pregnancy. For the entire sample, knowledge scores increased significantly (p = .000) from [T.sub.1] (preintervention) to [T.sub.2] (postintervention), and the adolescents who quit smoking had significantly higher knowledge at [T.sub.2] (p = .028) and greater increases ([T.sub.1] to [T.sub.2]) in their knowledge (p = .0 19) than did those who did not quit. Together, the TFS and TFSB groups had signifi cantly higher knowledge at [T.sub.2] (p = .017) and a significantly greater increase in knowledge from [T.sub.1] to [T.sub.2] (p = .005) than did the UCC group. This also held true when the TFS and TFSB groups were examined individually. Each had significantly higher knowledge at [T.sub.2] (TFS, p = .029; TFSB, p = .008) and a significantly greater increase in knowledge from [T.sub.1] to [T.sub.2] (TFS, p = .007; TFSB, p = .009) than did the UCC group. Furthermore, despite the small sample sizes, within-group comparisons showed (a) no significant differences between quitters and nonquitters in the UCC group, (b) significantly higher knowledge at [T.sub.2] (p = .052) and a trend indicating greater increases in knowledge from [T.sub.1] to [T.sub.2] (p = .092) for the quitters compared with the nonquitters in the TFS group, and (c) a trend for adolescents in the TFSB group who quit smoking to have greater increases in knowledge compared with those who did not quit (p = .158). These results indicate the need for continued inquiry into the relationship between pregnant teenagers' health knowledge and decisions to stop smoking.
Smoking cessation among adolescents remains a complex and unresolved issue. According to self-report data, slightly more than one in four American adolescents is a current smoker (Resnick et al., 1997). For female adolescents in particular, research has revealed increased access to tobacco (DiFranza, Savageau, & Aisguith, 1996), as well as a higher percentage of failed attempts to quit smoking (Brownson, DiLorenzo, Van Tuinen, & Finger, 1990).
National data indicate that 17.2% of pregnant females between the ages of 15 and 19 years are smokers (Mathews, 1998). Pregnancy compounds the ramifications of smoking. The association between smoking during pregnancy and multiple adverse outcomes, including maternal bleeding, low infant birthweight, infant mortality, and delays in child development (Cornelius, Taylor, Geva, & Day, 1995; Kleinman & Madans, 1985; McGrady, Sung, Rowley, & Hogue, 1992; Mercer, 1987; Schoendorf & Kiely, 1992; Walsh, 1994), is well-documented, and increases the importance of successful cessation.
In order to tailor cessation interventions to pregnant adolescents and enhance program effectiveness, it is critical to identify the specific variables that are relevant for this population. The purpose of the present study was to examine adolescents' knowledge of the detrimental effects of smoking on pregnant women and fetuses and its relationship to efforts to quit smoking.
The association between health knowledge and decisions to stop smoking is unclear. Although some research has pointed to the tendency for adolescents to engage m risk-taking behavior despite known dangers (Goodstadt, 1986; Irwin & Millstein, 1986; Silvis & Perry, 1987), recent studies have shown that teenagers do understand the ramifications of cigarette smoking and this serves as a major impetus to quit (Dozois et al. …