Fatherhood as Motivator Fatherhood as Motivator for Smoking Behaviour for Smoking Behaviour

ChangeChange

Jeffrey Gage RN, MPH, PhDJeffrey Gage RN, MPH, PhDChristchurch Polytechnic Christchurch Polytechnic Institute of TechnologyInstitute of Technology

Research supported by the Robert Research supported by the Robert Wood Johnson FoundationWood Johnson Foundation

BackgroundBackground

A supportive male partner is the most A supportive male partner is the most significant influencing factor on the success significant influencing factor on the success of smoking cessation during pregnancy of smoking cessation during pregnancy (McBride et al., 1998; Nafstad, Botten, & Hagen, 1996) (McBride et al., 1998; Nafstad, Botten, & Hagen, 1996)

The influence of the male partner is also the The influence of the male partner is also the strongest predictor for maternal quitting strongest predictor for maternal quitting and relapse post-deliveryand relapse post-delivery

(Mermelstein, Cohen, Lichtenstein, Baer, & Karmarck, 1986; Severson, (Mermelstein, Cohen, Lichtenstein, Baer, & Karmarck, 1986; Severson, Andrews, Lichtenstein, Wall, & Akers, 1997)Andrews, Lichtenstein, Wall, & Akers, 1997)

The state of Missouri was ranked 48The state of Missouri was ranked 48thth out of 50 out of 50 in all state health rankings for cigarette in all state health rankings for cigarette smoking smoking

(United Health Foundation, 2004)(United Health Foundation, 2004)

PurposePurpose

To develop a mid-range theory to To develop a mid-range theory to describe and explain male partner describe and explain male partner participation in smoking cessation participation in smoking cessation during pregnancyduring pregnancy

Grounded Theory DesignGrounded Theory Design

Constant comparison – data are collected Constant comparison – data are collected and analysed simultaneouslyand analysed simultaneously

Theoretical sampling – decisions about Theoretical sampling – decisions about which data are collected next are which data are collected next are determined by the theory that is being determined by the theory that is being constructedconstructed

SampleSample ► Individual interviews with 23 men from 15 towns in Mid-MissouriIndividual interviews with 23 men from 15 towns in Mid-Missouri

► Average age 22 yearsAverage age 22 years

► 19 White, 2 African American, 1 Bi-Racial, 1 Hispanic19 White, 2 African American, 1 Bi-Racial, 1 Hispanic

► Education:Education:

36% grades 6-1136% grades 6-1155% grade 12 or GED55% grade 12 or GED9% 1-3 years college9% 1-3 years college

► Employment:Employment:

19% employed full-time, 19% employed full-time, 2 unemployed 2 unemployed 1 student1 student 1 unable to work 1 unable to work

Smoking BehavioursSmoking Behaviours► 77% were current smokers77% were current smokers

► Average length of smoking 9.5 years; 19 Average length of smoking 9.5 years; 19 cigarettes per daycigarettes per day

► Four participants had quit smoking Four participants had quit smoking

► Two participants were non-smokersTwo participants were non-smokers

► Saliva cotinine analysis verified smoking and Saliva cotinine analysis verified smoking and non- smoking self reportsnon- smoking self reports

FindingsFindings

Fatherhood as Motivator for Smoking Behaviour Fatherhood as Motivator for Smoking Behaviour ChangeChange

FindingsFindings

► Pregnancy and preparation for fatherhood provided Pregnancy and preparation for fatherhood provided motivation for smoking behaviour changemotivation for smoking behaviour change

► First-time fathers described themselves as being more First-time fathers described themselves as being more motivated to change their smoking behaviours than other motivated to change their smoking behaviours than other fathersfathers

► Protecting the baby was the primary aim of first-time fathers Protecting the baby was the primary aim of first-time fathers during pregnancy and post-deliveryduring pregnancy and post-delivery

► Protection motivation, smoking goals and smoking behaviours Protection motivation, smoking goals and smoking behaviours were interpreted and reinterpreted during pregnancy and the were interpreted and reinterpreted during pregnancy and the transition to fatherhoodtransition to fatherhood

Baby’s Safe Arrival

FathersSmoke

Outside

TimePeriods

Motivation for Smoking Behavior Change

Fathers’ Smoking

Goal

Fathers’ Smoking Behavior

Post-Delivery

Protectionof Baby

Cut-down Smoking

Outcome

FathersSmoke Outside

Attempt to Quit

Independently or Together

Quit Smoking

Continue Smoking

The Reality of Fatherhood (First-Time

Fathers)

Pregnancy: Preparation

for Fatherhood

Beginning & Early

Pregnancy

Mid to Late Pregnancy

Protectionof Baby

Protectionof Baby

Smoking GoalsSmoking Goals

Beginning and Early Pregnancy:Beginning and Early Pregnancy:

““Within the week after having the baby, after we calm down, we Within the week after having the baby, after we calm down, we are just quitting.”are just quitting.”

Mid-to-Late Pregnancy: Mid-to-Late Pregnancy:

““Well I mean I figure if I just cut down I will probably be able to Well I mean I figure if I just cut down I will probably be able to stop smoking… I mean a pack lasts me two days, almost two and stop smoking… I mean a pack lasts me two days, almost two and a half days. So I figure get it up to three days, something like a half days. So I figure get it up to three days, something like that would be alright.”that would be alright.”

Post-Delivery:Post-Delivery:

““We still smoke, but we smoke outside because the baby’s here” We still smoke, but we smoke outside because the baby’s here”

ConclusionsConclusions

The transition to fatherhood may be viewed as The transition to fatherhood may be viewed as timeframe during which first-time fathers are timeframe during which first-time fathers are motivated to change smoking behaviourmotivated to change smoking behaviour

Smoking cessation motivation, goals, and behaviors Smoking cessation motivation, goals, and behaviors of first-time fathers, are likely to change during the of first-time fathers, are likely to change during the course of their transition to fatherhoodcourse of their transition to fatherhood

Fatherhood is perceived by some fathers as a Fatherhood is perceived by some fathers as a socially constructed role in the context of socially constructed role in the context of relationship with their partners relationship with their partners

Promotion of Promotion of smoking cessation smoking cessation for first-time for first-time fathers is potentially most effective during fathers is potentially most effective during beginning and early pregnancybeginning and early pregnancy

Strategies to encourage smoking behaviour change Strategies to encourage smoking behaviour change may be more efficacious if they are focused on the may be more efficacious if they are focused on the theme of theme of protection of babyprotection of baby from the effects of from the effects of cigarette smokecigarette smoke

During mid-to-late pregnancy and post-delivery it During mid-to-late pregnancy and post-delivery it may be more prudent to emphasize harm reduction may be more prudent to emphasize harm reduction strategies with first-time fathers rather than strategies with first-time fathers rather than smoking cessation smoking cessation

Fatherhood as Motivator Fatherhood as Motivator for Smoking Behaviour for Smoking Behaviour

ChangeChange

Jeffrey Gage RN, MPH, PhDJeffrey Gage RN, MPH, PhDChristchurch Polytechnic Christchurch Polytechnic Institute of TechnologyInstitute of Technology

Research supported by the Robert Research supported by the Robert Wood Johnson FoundationWood Johnson Foundation