Motivating Smoking Cessation Text Messages: Perspectives from Pregnant Smokers
The purpose of this research is to analyze cessation text-messages written by pregnant smokers to elucidate the target population’s preferred content and message attributes. To achieve this goal, the objectives of this study are three-fold; to qualitatively code messages written by pregnant smokers for frame, type of appeal, and intended target.
Study participants were recruited as part of a larger trial of pregnant smokers who were enrolled in a text-messaging program or control group and surveyed 1 month post-enrollment. Each participant was asked to write a brief message to another pregnant smoker and two independent coders qualitatively analyzed responses.
User generated messages (N = 51) were equally loss and gain framed, and the most common appeals were: fear, guilt, cognitive, hope and empathy, in order of most to least frequent. The target of the majority of the messages was the baby.
Conclusions for Practice
Allowing pregnant smokers to write cessation text-messages for other pregnant women can provide relevant insight into intervention content. Specifically, pregnant smokers appear to equally promote gain and loss frames, but may prefer messages that include components of fear and guilt related to the impact of smoking on their baby. Additional research is needed to systematically uncover perspectives of pregnant smokers to ensure interventions are optimally effective.
KeywordsTobacco Cessation Pregnancy mHealth
This work was partially funded by a Grant from the National Institutes of Health (R15-CA167586).
Compliance with Ethical Standards
Conflict of interest
The authors declare they have no conflicts of interest.
- Abroms, L. C., Johnson, P. R., Heminger, C. L., Van Alstyne, J. M., Leavitt, L. E., Schindler-Ruwisch, J. M., & Bushar, J. A. (2015). Quit4baby: Results from a pilot test of a mobile smoking cessation program for pregnant Women. JMIR mHealth and uHealth, 3(1), e10. https://doi.org/10.2196/mhealth.3846.CrossRefPubMedPubMedCentralGoogle Scholar
- Cooper, S., Foster, K., Naughton, F., Leonardi-Bee, J., Sutton, S., & Coleman, T. (2015). Pilot study to evaluate a tailored text message intervention for pregnant smokers (MiQuit): Study protocol for a randomized controlled trial. Trials, 16(1), 29. https://doi.org/10.1186/s13063-014-0546-4.CrossRefPubMedPubMedCentralGoogle Scholar
- Fiore, M. C., Jaen, C. R., Baker, T. B., Bailey, W. C., Benowtiz, N. L., Curry, S. J., & Wewers, M. E. (2008). Treating tobacco use and dependence: 2008 update. Retrieved from http://bphc.hrsa.gov/buckets/treatingtobacco.pdf.
- Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381.CrossRefPubMedGoogle Scholar
- Nabi, R. L. (2002). Discrete emotions and persuasion. The persuasion handbook: Developments in theory and practice, Thousand Oaks: Sage Publications, p. 308.Google Scholar
- National Cancer Institute. (2015). SmokefreeMOM: About. Retrieved from: http://women.smokefree.gov/smokefreemom.aspx.
- National Institutes of Health. (2015). SmokefreeMOM: Reaching pregnant smokers with health information via text messaging. Retrieved from: https://clinicaltrials.gov/ct2/show/NCT02412956?term=SmokefreeMOM&rank=1.Google Scholar
- Office of Disease Prevention and Health Promotion. (2015). Healthy People 2020: Maternal, infant, and child health. Retrieved from: http://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives.
- Pew Research Center (2015a). Mobile Technology Fact Sheet. Retrieved from: http://www.pewinternet.org/fact-sheets/mobile-technology-fact-sheet/.
- Polen, K. N. D., Sandhu, P. K., Honein, M. A., Green, K. K., Berkowitz, J. M., Pace, J., & Rasmussen, S. A. (2014). Knowledge and attitudes of adults towards smoking in pregnancy: Results from the HealthStyles© 2008 survey. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-014-1505-0.Google Scholar
- StataCorp. (2013). Stata Statistical Software: Release 13. College Station, TX: StataCorp LP.Google Scholar
- Tong, V. T., Dietz, P. M., Morrow, B., D’Angelo, D. V., Farr, S. L.… England, L. J. (2013). Trends in smoking before, during and after pregnancy—pregnancy risk assessment monitoring system, United States, 40 Sites, 2000–2010. Morbidity and Mortality Weekly Report, 62 (SS06), 1–19. Retrieved from: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6206a1.htm?s_cid%3Dss6206a1_x#Tab2.
- Turner, M. M. (in press). Guilt and shame. In R. Parrott (Ed.), Oxford research encyclopedia of communication. Oxford: Oxford University Press.Google Scholar
- U.S. Department of Health and Human Services (2014). The health consequences of smoking: 50 years of progress. A report of the surgeon general. Chapter 9: Reproductive outcomes. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.Google Scholar
- Underhill, J. C. (2012). Examining the effects of hope and fear appeals on cognitive processing (Doctoral dissertation). Digital repository at the University of Maryland. Retrieved from: http://drum.lib.umd.edu/handle/1903/13196.
- Van Mierlo, T., Fournier, R., Jean-Charles, A., Hovington, J., Ethier, I., & Selby, P. (2014). I’ll Txt U if i have a problem: How the Socie ́te ́ Canadienne du Cancer in Quebec applied behavior-change theory, data mining and agile software development to help young adults quit smoking. PloS ONE, 9(3), e91832. https://doi.org/10.1371/journal.pone.0091832.CrossRefPubMedPubMedCentralGoogle Scholar