Reviewer's report
Title:Socio-demographic factors and processes associated with stages of
change for smoking cessation in pregnant versus non-pregnant women.
Version: 1Date:30 June 2010
Reviewer: Monique Baha
Reviewer's report:
This is a well written article which provides useful insights on the understanding
of smoking during pregnancy and could be used to design cessation
interventions for pregnant smokers. However, there are some major
weaknesses.
• Major Compulsory Revisions
Methods:
Were tobacco-related information (such as number of cigarettes smoked daily or
level of dependence) collected during the interviews? For women who were
ex-smokers, for how long had they been abstinent? Were these women
spontaneous quitters or had they been offered smoking cessation counselling? If
none of the above information were collected or if data were omitted on purpose,
this is a limit which should be mentioned and discussed.
Results:
In the paragraph on stages of change: adding information for instance on the
duration of abstinence (if available) would complement the profile of pregnant
ex-smokers who maintained abstinence. Information on the level of dependence
or the number of cigarettes smoked would help better describe women who are
pre-contemplative.
In the methods, last sentence in the paragraph “design”, the authors describe the
acceptability of smoking questionnaire as a measure of women’s perception of
the acceptability of smoking in different groups. Unfortunately, detailed results
are not presented. It would be interesting to discuss whether pregnant smokers
view their own smoking as more (or less) acceptable than others’.
Discussion:
I’m afraid that the socio-demographic profile of pregnant smokers is a well
documented result (see for example, Schneider et al. The European Journal of
Contraception & Reproductive Health Care 2008, or Ebert and Fahy Women and
Birth 2007). Authors should acknowledge that and present their findings in a way
which clearly shows what this study adds to the body of knowledge, instead of
simply confirming existing results.
In my opinion, key findings of this study are: the scores of experiential and
behavioural processes between stages of change by group of women, scores on
the situational temptation measure, and the acceptability of smoking between
stages of change by group of women.
Conclusion:
Results from this study should allow the authors to draw conclusions with more
relevant implications for smoking cessation interventions during pregnancy: for
instance, the importance of evaluating the social situations and craving situations
that women face, especially at earlier stages of change. Authors could also
mention that future interventions should focus on the inability of pregnant
smokers to apply behavioural coping mechanisms by themselves.
Abstract:
Results on the acceptability of smoking should be mentioned in the results
section.
The conclusion presented here may not be the most accurate considering that
findings in terms of social situations or social acceptability of smoking reveal
similarities between pregnant and non-pregnant women.
• Minor Essential Revisions
Methods:
In the paragraph on sample: Would the authors mind explaining what they mean
by “healthy” women? Does it mean for instance that women suffering
cardiovascular or respiratory diseases were not included?
Discussion:
In the second paragraph please rephrase “education confers wisdom regarding
health”.
Tables:
It seems information presented in table 1 is redundant with the figures.
References:
Reference (30) is listed in the references section but not mentioned in the text.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.