Abstract
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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.
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