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Barriers to success: smoking cessation conversations

02 August 2017
12 min read
Volume 25 · Issue 8

Abstract

Using the structure of Azjen's (1991) health behaviour model, this article examines the experience of promoting smoking cessation in a woman's booking appointment. Smoking cessation is a key contributor to adverse health outcomes, and is a priority for health professionals on a local and national scale. Conversations surrounding smoking cessation in pregnancy are often seen as difficult; midwives are often concerned they may harm the developing midwife-woman bond. The use of non confrontational brief intervention based methods may aid health professionals by creating a positive image of behaviour change. Barriers to the success of the intervention are discussed, including institutional pressures alongside ineffective communication skills, and suggestions for future practice are made. The importance of involving partners or family members in health promotion barriers to aid success is highlighted and demonstrates the wider impact midwives have on public health.

The concept of public health involves national and local health initiatives, health education and the creation of social and physical environments to protect and promote population health (Dawson and Verweij, 2015). Health promotion is an integral part of the midwife's role, not only for the woman, but for her family and the wider community (International Confederation of Midwives, 2011; Nursing and Midwifery Council (NMC), 2015). Despite widely accepted health risks and available support, the use of tobacco products remains a health issue in the UK, and smoking cessation is a key health promotion topic for midwives. The experience of promoting smoking cessation in a woman's booking appointment triggered the author to examine the challenges of encouraging a health behaviour change. The woman and her partner were both smokers, and the author's experience is used in the form of a case study to demonstrate the barriers to success encountered by health professionals. Communication methods are discussed, and Ajzen's theory of planned behaviour (Ajzen, 1991) is used to explore the woman's personal attitude, subjective norms and perceived external barriers, before the woman's likelihood to change is determined. Verbal consent from the woman and her partner was gained, and identifying features of the case have been anonymised in compliance with midwives' professional responsibility to maintain confidentiality (NMC, 2015).

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