Understanding Pregnant Smokers' Adherence to XXXX Replacement Therapy During a Quit Attempt: A Qualitative Study.

@entity1 @entity1239
BACKGROUND: Pregnant smokers may be offered @entity1239 replacement therapy (NRT) alongside behavioral support to assist with a quit attempt. Yet trials of NRT have found adherence to be low among pregnant @entity1 , and this has made it difficult to determine the efficacy of NRT. The aim of this study is to understand the experience of pregnant @entity1 who use NRT but discontinue this early or do not use the medication as recommended. METHODS: Semi-structured telephone interviews were conducted with 14 pregnant smokers who had recently been prescribed NRT, but self-reported poor NRT adherence or discontinuing treatment prematurely. Data were transcribed and analyzed using inductive thematic analysis RESULTS: There were four main themes identified; expectations of NRT, experience of using NRT, safety concerns and experience of using e-cigarettes. Some @entity1 intentionally used NRT to substitute a proportion of their cigarette intake and smoked alongside. Most @entity1 smoked while using NRT. @entity1 who underutilized NRT did so as they experienced side effects, or were concerned that using NRT instead of smoking could actually increase their @entity1239 exposure and potential for increased @entity1239 dependence or fetal harm. Most @entity1 spoke about the use of e-cigarettes as a smoking cessation method but only a few had actually experienced using them during pregnancy. CONCLUSION: Many @entity1 underused NRT but simultaneously smoked. Challenging negative perceptions about NRT and educating @entity1 further about the risks of smoking may encourage them to use NRT products as recommended. IMPLICATIONS: These findings add to the research surrounding the efficacy of NRT during pregnancy by providing insight into how pregnant @entity1 use NRT during a quit attempt and how this may influence adherence. It may assist health professionals to support pregnant smokers by increasing their understanding about the differing ways in which @entity1 use NRT and help them address concerns @entity1 may have about the safety of NRT.
