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Am J Perinatol 2023; 40(08): 906-911
DOI: 10.1055/s-0041-1732420
Original Article

Perspectives about Environmental Tobacco Smoke Exposure from Mothers of Premature Infants

Bryanne N. Colvin 
1   Department of Pediatrics, Washington University School of Medicine, Saint Louis, Missouri
,
Margaret G. Parker
2   Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
3   Slone Epidemiology Center, Boston University School of Medicine, Boston, Massachusetts
,
Sunah S. Hwang
4   Section of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
,
Emma S. Forbes
3   Slone Epidemiology Center, Boston University School of Medicine, Boston, Massachusetts
,
Kyria Brown
5   Graduate School of Social Work, Colorado School of Public Health at the University of Colorado-Anschutz, Aurora, Colorado
,
Eve R. Colson
1   Department of Pediatrics, Washington University School of Medicine, Saint Louis, Missouri
› Author Affiliations Funding B.N.C., M.G.P., E.S.F., K.B., and E.R.C. report grants from Eunice Kennedy Shriver National Institute for Child Health and Development at the National Institute of Health (R01 HD095060; PI Parker/Hwang) during the conduct of study.
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Abstract

Objective The study aimed to better understand the perceptions of mothers of preterm infants regarding smoking behaviors and environmental tobacco smoke (ETS) exposure using qualitative methodology.

Study Design Using a Grounded Theory approach, we conducted in-depth, semi-structured interviews with mothers of preterm infants, both smokers and nonsmokers. Using the Theory of Planned Behavior (TPB) as a conceptual framework for our questions, we conducted and analyzed interviews until theoretical saturation was reached. Analysis included an iterative coding process resulting in theme development.

Results Our key themes aligned with the TPB domains of attitudes, perceived control, and social norms. Regarding attitudes, mothers expressed that smoking was bad for their infants and that preterm infants were more vulnerable than term infants. Regarding perceived control, mothers commented on their perceived ability to avoid ETS exposure with subthemes including strategies utilized to mitigate ETS exposure risk. Some mothers expressed difficulty avoiding ETS exposure, for example, when residing in high-density housing. Regarding perceived social norms, mothers whose family and friends were nonsmokers expressed ease avoiding ETS, while mothers whose family and friends were smokers expressed more difficulty avoiding ETS.

Conclusion Mothers used a variety of behaviors within the domains of the TPB to reduce ETS exposures in their preterm infants which can inform future neonatal intensive care unit-based interventional strategies.

Key Points

  • Mothers felt ETS is harmful for preterm infants.

  • Mothers reported strategies for ETS avoidance.

  • Mothers reported barriers to ETS avoidance.

  • TPB can frame mothers' ETS-related behaviors.

Keywords

smoking - prematurity - theory of planned behavior - environmental tobacco smoke


Publication History

Received: 20 January 2021

Accepted: 01 June 2021

Article published online:
16 July 2021

© 2021. Thieme. All rights reserved.

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