Moderating effect of partner smoking on pregnant women’s intention to stop smoking: applying the reasoned action approach

Abstract

Background: Pregnant women are a priority for cessation interventions. Guided by the Reasoned Action Approach, this study tested whether partner’s smoking status moderated the effects of attitude, perceived norm, and perceived behavioral control on intention to take measures to quit smoking among a sample of pregnant women.

Methods: Women (N = 288) who reported smoking were recruited during their first prenatal visit to a clinic-based intervention study. Clinic staff referred potentially eligible women to study staff who confirmed eligibility and conducted a baseline survey. Multiple linear regression analyses examined the effect on intention of attitude, perceived norm, perceived behavioral control, age, nicotine dependence, and partner smoking as well as two-way interactions between partner smoking and attitude, perceived norm, and perceived behavioral control.

Results: Perceived behavioral control (β = .536, p = .000) and perceived norm (β = .233, p = .000) were significantly associated with intention to stop smoking. There were no significant effects of attitude, age, nicotine dependence, or partner smoking. The main effect of perceived norm was modified by an interaction with partner’s smoking status (β = .365, p = .009). Probing this interaction revealed that the weight for perceived norm was statistically significant for women with a smoking spouse or romantic partner (β = .356, p = .000) but not for women without one (β= −.006, p = .955).

Conclusions: Interventions for pregnant smokers should focus on increasing perceived behavioral control to take measures to stop either by improving perceived skill or by modifying the environment to make stopping easier. Perceived norm can be a useful target for change, but only for women with romantic partners who smoke cigarettes.

Keywords:

• Beliefs
• smoking cessation
• reasoned action approach
• pregnant smokers

Disclosure statement

None of the authors have any conflicts of interest.

Notes

1 We conducted a sensitivity analysis by replicating the regression analysis after removing participants with no spouse/romantic partner. The pattern of results was unchanged, but the interaction of partner smoking with perceived norms failed to reach statistical significance at the p<.05 level most likely due to inadequate statistical power to detect an interaction effect due to the reduced sample size. After splitting the file by spouse/romantic partner, the findings were unchanged. That is, for those with a spouse/romantic partner who smoked, perceived norms was significantly related to intention (β = .356; p = .000), but for those with a nonsmoking spouse/romantic partner, there was no relationship (β = .130; p = .363).

Additional information

Funding

This work was supported by the Maternal and Child Health Services Block Grant to the States from Department of Health and Human Services [Award Number: B04MC29342]. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Department of Health and Human Services. The study sponsor had no role in study design; collection, analysis, and interpretation of data; writing the report; and the decision to submit the report for publication.