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Institute of Epidemiology & Health Care

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Development of a smoking cessation smartphone application for pregnant smokers focusing on the role of identity

Author I. Tombor
Author R. West
Author L. Shahab
Author J. Brown
Abstract This thesis reports two strands of work leading to the creation of a smartphone application harnessing identity change to promote smoking cessation during pregnancy. The first strand studied the role of smoker identity in smoking cessation. Using data from a national prospective study of smokers in England, Study 1 found that most young women do not have a positive smoker identity but that those who do are less likely to try to quit smoking, independent of other smoking-related attitudes. Study 2 used prospective national survey data and showed that adopting a non-smoker identity after a quit attempt predicts medium-term abstinence. Study 3 was a meta-ethnography of smoker identity in young adults and found that multiple smoker identities evolve depending on the context and that these do appear to play a role in cessation. The second strand related to the development of the application itself. Using interviews with pregnant smokers, Study 4 found that, from their perspective, stopping smoking would require strong enough motivation, improved ability and a supportive social and physical environment. Study 5 involved focus groups of health professionals working with pregnant smokers and solicited recommendations regarding the design and delivery of digital cessation aids in pregnancy. Study 6 used data from a pilot randomised controlled trial of the smoking cessation website, MumsQuit, to assess associations between exposure to particular components and four-week continuous abstinence. Six behaviour change techniques were associated with abstinence: promoting problem solving, providing feedback on behaviour, promoting self-monitoring of outcomes of the behaviour, providing feedback on outcomes of the behaviour, providing social reward, and promoting self-reward. The thesis concludes with a description of the development of a smartphone application, SmokeFree Baby, based on preceding work.