Blogging to Quit Smoking

Smoking during pregnancy has adverse outcomes for the mother, the pregnancy, the fetus, and the baby. For women who are pregnant, smoking increases the risk of having an ectopic pregnancy, abruption placentae, placenta previa, and a miscarriage. Smoking during pregnancy also increases the chances of a newborn baby: (1) being born prematurely, (2) having a low birth weight, (3) having difficulty in feeding, (4) having birth defects, including cleft lip/cleft palate, and (5) dying of sudden infant death syndrome.

Approximately 10.6% of pregnant women in Ontario smoke; 75% of pregnant women in Ontario who smoke want to quit. Despite their intentions and efforts to quit smoking, many pregnant smokers do not access public health venues for assistance due to low awareness of available supports and to stigma, shame, and guilt associated with smoking during pregnancy. Some researchers have postulated that journaling is an effective behavioral intervention for helping people quit smoking, and psychologists find that expressive writing has therapeutic properties.

Prevention of Gestational and Neonatal Exposure to Tobacco Smoke (PREGNETS) is an online platform offered by the Centre for Addiction and Mental Health to provide support and informational resources to pregnant and postpartum women and their health care providers. PREGNETS offerings include an informative website, discussion board, Facebook page, and a blog. The PREGNETS blog was developed to provide a more accessible space for women with the lived experience of pregnancy and tobacco use to engage in expressive writing via an online medium. In partnership with the Ontario Women's Health Network (OWHN), PREGNETS encouraged bloggers to write reflection pieces about their experiences with smoking and pregnancy, reviews of services designed to address their needs, lists to summarize their experiences or motivations, or personal letters to express their feelings toward their support networks.

Five women who blogged for PREGNETS were interviewed about their experiences as bloggers. Key themes that emerged from blogger interviews include:

1. Blogs provide an opportunity for self-reflection: the blogging process provided an opportunity for bloggers to reflect on their smoking behaviors, reevaluate their motivations for smoking, or reinforce their existing feelings about themselves.
"It reminded me of the things that I may have forgotten about, and the things that I'm capable of doing."

2. The blogging process has practical benefits: Whether writing kept their hands busy, or offered a therapeutic outlet, bloggers enjoyed the practical advantages of the writing process.

"Me writing it down, making these small goals for me, would actually help me."
3. Bloggers feel connected to their peers: Knowing other women's experiences and insights reassured bloggers that they were not alone.

"I know I haven't met them but I like reading some of the stuff and connect with them."

4. Blogging increased the level of support received from others: The majority of bloggers expressed having at least one form of support, which they found encouraged them during the blogging process and through their quit journeys.

"My spouse-I had a lot of input from him...he has a lot to say about what should be put in my blogs and he has read over a few of them and he said that they were good."

Findings suggest that blogging might combine several evidence-based behavioral strategies for tobacco cessation, such as journaling and getting support from others who use tobacco. Being part of a blogging community of women who have experienced or are experiencing similar challenges can be therapeutic and help women gain confidence in their ability to quit smoking. As one blogger reflected, "I was smoking a pack or more a day. And now with PREGNETS [blog], I've been down to five or ten a day."

Aliya Noormohamed (1), Nadia Minian (1), Rosa Dragonetti (1), Julie Maher (2), Christina Lessels (2) and Peter Selby (1, 3-6), are authors of the recently published paper Blogging to Quit Smoking: Sharing Stories from Women of Childbearing Years in Ontario, available for download now in Substance Abuse: Research and Treatment.

1. Centre for Addiction and Mental Health, 2. Ontario Women's Health Network, 3. Department of Family and Community Medicine, University of Toronto, 4. Department of Psychiatry, University of Toronto, 5. Dalla Lana School of Public Health, University of Toronto, 6. Ontario Tobacco Research Unit.

*This blog was originally posted on the Libertas Academica's Public Science Insights site