Postpartum Period, Smoking Relapse Behavior
Conditions
Keywords
Motivational Interviewing, Digital Game, Antenatal care, Smoking relapse
Brief summary
This randomized controlled trial aims to determine the effect of motivational interviewing-based, digital game-supported counseling on postpartum smoking relapse among pregnant women who quit smoking spontaneously during pregnancy. Women who smoked at least one cigarette per day before pregnancy and quit smoking during pregnancy will be included. Participants will be randomly assigned to two groups: in the intervention group, online motivational interviewing sessions will be delivered once each during the third and fourth prenatal follow-ups by the researcher, and a digital game assignment will be provided after each session; the control group will receive routine health counseling delivered during prenatal follow-ups. The primary outcome measure is the rate of smoking relapse at three months postpartum. Secondary outcome measures include the postpartum slip rate, craving to smoke, and motivation to remain abstinent.
Interventions
BEHAVIORALMotivational Interviewing and Digital Game-Supported Counseling
Collaborative, autonomy-supportive counseling delivered in two structured sessions using motivational interviewing techniques, scheduled during the 3rd and 4th routine antenatal visits. The counseling focuses on sustaining abstinence, coping with cues, relapse prevention, and managing partner/household exposure. Each session follows a manualized protocol, with a session checklist completed at every visit. After each session, participants are assigned a digital game-based task designed to reinforce key counseling themes and support behavior maintenance.
BEHAVIORALRoutine Antenatal Care
Routine antenatal care is provided at the study hospital according to the Ministry of Health's pregnancy follow-up program, which includes visits at ≤14 weeks, 18-24 weeks, 28-32 weeks, and 36-38 weeks of gestation.
Sponsors
Lokman Hekim University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
A randomized controlled experimental study with pre-test post-test parallel design
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged ≥18 years * Being in the second trimester of pregnancy * Smoked at least one cigarette per day before pregnancy and quit smoking during the first trimester of pregnancy * Have internet access * Own a device capable of playing the digital game (e.g., smart phone, tablet, or computer) * Native Turkish speakers
Exclusion criteria
* Having a diagnosis of any psychiatric disorder * Currently using another pharmacological or behavioral smoking cessation method * Having a high-risk pregnancy Withdrawal Criteria: * Experience pregnancy termination for any reason * Do not participate in any stage of the counseling sessions * Are diagnosed with postpartum depression during the postpartum period * Resume smoking during pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Point prevalence abstinence | At 3 months postpartum | 7-day point prevalence abstinence at 3 months postpartum |
| Continuous abstinence | At 3 months postpartum | Continuous abstinence rate at 3 months postpartum |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Motivation for smoking abstinence | At baseline, and at 1, 2, and 3 months postpartum | Assessed using the Turkish version of the Abstinence-Related Motivational Engagement (ARME) Scale, which evaluates participants' motivation to maintain smoking abstinence through total scale scores. |
| Level of cigarette craving | At baseline, and at 1, 2, and 3 months postpartum | Measured using a self-reported 0-10 rating scale for cigarette craving (0 = no craving, 10 = extreme craving). |
| Prevalence of slips | At 1, 2, and 3 months postpartum | Prevalence of slips |
Countries
Turkey (Türkiye)
Contacts
Primary ContactNurbanu ODACI
Outcome results
None listed