Cognitive and behavioral predictors in the process of smoking cessation during pregnancy: Testing for discontinuity patterns in the Transtheoretical Model

The aim of the study was to assess predictive power of cognitive variables and health-promoting behaviors for the process of smoking cessation described in terms of the Transtheoretical Model (TTM). Participants in the study were 150 women (mean age 26.93, SD = 4.56 years), in uncomplicated pregnancy. Cigarette smokers constituted 29.3% of the sample, while the rest had previously quitted smoking (in that number 42.1% during pregnancy). Beliefs and expectations were measured by means of scales developed by the author, while health-related behaviors were assessed using the Health Behavior Inventory (HBI) by Z. Juczyński, supplemented with pregnancy-specific behaviors. TTM discontinuity patterns were tested in the study using polynomial-based orthogonal contrasts. Statistically significant linear trends were found for expectations concerning the infant's health state and the course of delivery, for beliefs about the effect of maternal smoking on infant health, as well as for pregnancy health behaviors. The obtained results were confirmed by hierarchical regression analysis, with smoking cessation explained to a larger extent by cognitive factors than by health-related behaviors. This may suggest that the TTM is a "pseudo-stage" model, and a general change of the variables under study is of greater importance for the process of smoking cessation than focusing on the TTM stages.