The effect of smoking cessation intervention according to a web-based transtheoretical model in pregnancy on postpartum smoking relapse

Pregnancy motivates women to quit smoking, and many pregnant smokers successfully do so. However, a substantial proportion of these women relapse during the postpartum period. Digital platforms may be effective in helping pregnant women both quit smoking and maintain abstinence after delivery. The aim of this study was to evaluate the effectiveness of a web-based smoking cessation intervention based on the Transtheoretical Model (TTM), delivered during pregnancy, in preventing postpartum smoking relapse. This study employed a prospective, pretest-posttest randomized controlled design. The sample consisted of 70 pregnant women who smoked (experimental group, n = 34; control group, n = 36). Data were collected using the Participant Introduction Form, the Fagerstrom Test for Nicotine Dependence (FTND), the Stages of Change (SoC), the Processes of Change (PC), the Self-Efficacy (SE), and the Decisional Balance (DB) scales. Women in the experimental group received a TTM-based smoking cessation intervention delivered through a web application, consisting of five tailored animated videos (5–10 minutes each), throughout pregnancy until delivery. The control group received standard prenatal care without access to the digital intervention. Women in the experimental group demonstrated significant progression through the stages of change (SoC) compared with the control group. Mean FTND scores decreased, whereas mean PC, SE, and DB scores increased in the experimental group compared with the control group ( p < 0.05). Postpartum cigarette consumption was lower in the experimental group, and postpartum smoking relapse was significantly less frequent in this group than in the control group. The findings demonstrated that a web-based smoking cessation intervention grounded in the Transtheoretical Model, delivered during pregnancy, effectively reduced the likelihood of postpartum smoking relapse. Number (ClinicalTrials.gov) and date: NCT05711225, 12/12/2022, retrospectively registered.