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Health Education Research Advance Access published online on October 12, 2004
Health Education Research, doi:10.1093/her/cyg127
© 2004 by Oxford University Press
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Received April 10, 2004
Accepted September 6, 2004

Original article

Making sense of the challenge of smoking cessation during pregnancy: a phenomenographic approach

Agneta Abrahamsson 1*, Jane Springett 2, Leif Karlsson 3, and Torgny Ottosson 4

1 Department of Health Sciences, Kristianstad University, Kristianstad 291 88, Sweden, and Department of Community Medicine, Lund University, Malmö 205 02, Sweden
2 Institute for Health, School of Applied Social Sciences, Liverpool John Moores University, Liverpool L2 2ER, UK and Department of Health Sciences, Kristianstad University, Kristianstad 291 88, Sweden
3 Department of Health Sciences, Kristianstad University, Sweden
4 Department of Behavioral Sciences, Kristianstad University, Kristianstad 291 88, Sweden

* To whom correspondence should be addressed. E-mail: Agneta.Abrahamsson{at}hv.hkr.se.


  Abstract

In general, most women are familiar with the need to stop smoking when they are pregnant. In spite of this, many women find it difficult to stop. Using a phenomenographic approach, this study explored Swedish pregnant and post-pregnant women's ways of making sense of smoking during pregnancy. A total of 17 women who either smoked throughout pregnancy or stopped smoking during pregnancy were interviewed. Five different story types of how they are making sense of smoking during pregnancy were identified: smoking can be justified; will stop later; my smoking might hurt the baby; smoking is just given up; smoking must be taken charge of. Based on the study it is argued that the approach used in health education in relation to smoking cessation in antenatal care needs to move from information transfer and advice-giving to the creation of a dialogue. The starting point should be the woman's knowledge, concerns, rationalizations and prejudices. A model is suggested in which a woman may move in a space on three axes depending on life encounters, dialogue and reflections on meaning. The goal in health education would be to encourage movement along three axes: ‘increase of self-efficacy towards control’, ‘increase awareness by reflection on meaning of the smoking issue’ and ‘avoidance of defense of the smoking behavior’.


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[Abstract] [Full Text] [PDF]


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