Health Promotion Campaign on Smoking Cessation During Pregnancy

This document discusses the design and execution of a health promotion campaign on smoking cessation during pregnancy. It includes strategies, theories, and relevant statistics on smoking during pregnancy.

Running head: Health promotion campaign on the smoking cessation during pregnancy
Health promotion campaign on the smoking cessation during pregnancy
Name of the student
Name of the university
Author’s note

1Health promotion campaign on the smoking cessation during pregnancy
Response to Que 1:
I. Designing and execution of health promotion campaign on smoking cessation among the
pregnant women.
As a newly employed Health Promotion Officer, a campaign like ‘Healthy Start’ can be
designed and execute to reduce the smoking problem among the pregnant women. This
campaign can help the pregnant women buy basic things required for children or babies like
foods; fruits, milk, vegetables and infant formula. This scheme can also help gain benefits like
 Pregnancy vitamins
 Breastfeeding vitamins
 Vitamins for children who are below the age of 5 years old.
 Vitamins supplements.
This campaign is only the women who are either 10 months pregnant or have a single child
whose age is below 4 years old.
II. Theories and some basic approaches aimed at the reducing the smoking problems among
the pregnant women.
During pregnancy, there are many risks, which are associated with smoking and have an
adverse health effect causing wide range of pregnancy outcome, such as placental abruption,
miscarriage, preterm birth and low birth weight. Compounds like nicotine and other harmful
elements, which are present in cigarettes, can cause developmental toxicants. The consumption
of such compounds restricts the oxygen supply and other nutritional elements to the body
resulting retardation of fetal growth (Chamberlain, 2017).

2Health promotion campaign on the smoking cessation during pregnancy
Some of the approaches, which are aimed at reducing the action of smoking during
pregnancy:
Measures taken across the wide population: Implication of some laws like; ban on smoking,
mass media campaigns, intervening in an organization (work-site or school place), awareness
about the tobacco dependent medical treatment, advertisement on the health risk with the tobacco
consumption, prevention on tobacco use in public place.
Intervention among a community: programs include family involvement, group analyses,
intervention among the family and health care for the reduction in environmental tobacco
consumption, school policies and programs.
Some of the important approaches include individual participation and strategies for the
promotion of smoking cessation during pregnancy:
 Giving professional or personal guidance and advices by using different tools such as e-
resources, mass media and some behavioural and motivational therapy.
 Observation of the fetal health status and health risk associated with the tobacco by-
products to the mother.
 Advice for health care therapy and pharmacological intervention
 Support and encouragement from the social platform, which could include rewarding for
cessation
Choi (2014) described some of the self-determination theories that could be applied to examine
health behaviour especially in cessation of smoking:
 Autonomy
 Competence
 Relatedness

3Health promotion campaign on the smoking cessation during pregnancy
These are the vital factor for an individual for long-term behavioural changes to
determine the intrinsic motivation. These factors address the basic need, which are expected to
have great and stable effect of changed smoking behaviour.
III. Relevant Statistics and information from a local borough on smoking during
pregnancy
In the current context, the chosen borough is the Birmingham where the prevalence of pregnant
smoker is higher compared to the other borough. In Birmingham, one in 12 pregnant women are
smokers at the time they give birth or they expected to give birth. NHS statistics highlighted tahr
16, 091 women in the Birmingham city gave birth in 2017/2018. Despite the presence of the
higher risk of mother and bay related to the smoking, 1320 of these women gave birth to a baby
every day. Consequently, they experience the miscarriage, premature birth, low birth Wight and
many other complications related to the pregnancy. Even considering the previous records, in
2011 the prevalence of smokers during pregnancy was also high compared to any other borough
in England. Every year, 287000 women die due because of pregnancy of complications and
smoking plays a role as a crucial contributor to the mortality rate. () highlighted that one woman
out of every eight pregnant women is smoking during their pregnancy. However, the rate
decreased over time because of the smoking cessation policies implemented by the governing
bodies in the United Kingdom. () highlighted that in Birmingham, approximately, 3% of the
pregnant women in population is experiencing miscarriage due to smoking. Therefore, smoking
not only affected their physical wellbeing but also influenced the mental wellbeing of pregnant
women which further influence later life and life of the baby. However, the current literature
covering smoking of pregnant women highlighted that in 2017 to 2018 due to the presence of
smoking cessation policies or alternative therapies such as nicotine patch or e-cigarette,

4Health promotion campaign on the smoking cessation during pregnancy
Birmingham is still in a better position compared to entire nations. Where the pregnant smokers
in the where one out of 12 women observed in Birmingham, in other boroughs of England where
the pregnant smokers are one out of eight pregnant women. This result further indicates that the
government initiatives are fruitful to provide a smoking-free environment to the pregnant women
for the wellbeing of mother and baby. Therefore, further health promotions and health initiatives
are required to reduce smoking.
IV. Identification and evalution of two health promotion theories.
There are many theories and models which help to continue the practice of helth
promotion and disease prevention. These theories and model are applied in planning the
program, to understand, and to demonstrate the health behaviour.
Two of the theories which could be used for health care promotion and disease prevention
progarms are :
 The health Belief Model
This model is theoritical based model which can be used to conduct the health care
promotion and disease preventions programs. This model helps to demonstrate the change in
behaviour of an individual about health. So it is one of the widely used model for the better
understanding of human heath behaviour. The prime focus of this model is on the individiual
beliefs related to health conditions and behhaviour. The key factors which could influence the
health behaviour of an individual are: threat to sickness or disease, beliefs of consequences,
potential benefits and cofidence in the ability to succeed. . In the current context, changing the
health beliefs of individuals that smoking can give the release the negative thoughts or
complications regarding pregnancy can be amended for reducing the smoking habits of women.

5Health promotion campaign on the smoking cessation during pregnancy
Theory of social determinations:
Self-determination theory is defined as personality theory which involves the behavioral
factors and it focuses on the motivations behind choices the individuals makes which is
expressed through their behavior. Considering intrinsic motivations, a person seeks out
challenges and allow their growth and it is directly linked with the sense of security and
relatedness. Farholm et al. (2017) highlighted that autonomy, competence and relatedness
are three domain which motives the self-initiated behaviors of individuals. In the current
context, it was highlighted the majority of the pregnant smokers experienced pregnancy-
related complications due to frequent smoking habits during pregnancy, Therefore,
following the theory, pregreagan women can be assisted to change their behavior of
smoking and surroundings, develop goals to reduce smoking and strengthen their inner
power to adhere to quit smoking.
V. Discussion and planning of heath promotion and disease prevention strategies and its
impact in preventing the smoking action.
The process of enhancing and protecting the public health care unit is known as helath
promotion which incules the participation of individuals or a community. With a planned
activities and programs, this aim of health promotion and disease prevention can be esaily
achieved. The implementation of this health care prromotion can be of varied setting including
rural communities.
Eldredge et al (2016) discussed many theories, strategies and model which can be applied in
promoting health care and disease prevention among the rural communities. These theories and
strategies can be used to renovate and implement for the empowerment and motivation to people
for better health management.

6Health promotion campaign on the smoking cessation during pregnancy
The strategies for the health promotion and disease prevention are:
 Health communication: it includes strategies like verbal and written communication
which can influence and empower an individual or a community to decide a better choice
for healthier life. Some of the example of this strategy which are media based, are; radio,
newspaper, posters, social media.
Its impact on the action of smoking among the pregnant women: if such strategies are
implemented then the possibility of reducing the action smoking among the women will
increase.
Stress management:
It was highlighted that majority of the women are smoking cigarette because of their
stress regarding pregnancy and the relationship with their partners. Therefore, to replace
their frequent smoking habits, the healthy habits can be developed through assistance
such as consuming fruits on the daily basis, free hand exercise daily basis are effective
strategy (Mohamed‐Ahmed et al. 2016). Moreover, communicating with the community
members, surroundings and their partners are efficient strategy to reduce the stress
amongst the pregnant women. Therefore, frequently involving these activities such as
communications with partners able to reduce their habits and improves their well-being
(Green and Webb 2016).
Two communication strategies:
1. The first communications strategy is the face to face communications with the
relevant stakeholders such as pregnant women of the community. The communications
can be done for 30 minutes ever days in the community halls where each of the pregnant

7Health promotion campaign on the smoking cessation during pregnancy
women can be communicated about the adverse effect of smoking and how to improve
health during pregnancy and quit smoking through videos and power point presentations.
2. The second strategy is face to face communication with the registered nurse as well
as sending emails to the nurses giving instructions on how to provide the support to the
pregnant women and reduce the smoking habits of women (Singhal and Brown 2018).
For face to face communication with registered nurses, the similar strategy used such as
30 minutes ever days in the community where nurses were training for the gathering
skills regarding the management of stress, prenatal and perinatal care .
Response to the Question 2:
‘The Acheson’s report’ is a fully entitled independent into inequalities in health report which
was published in 1988 by unite Kingdome inquire head, Donald Acheson. The purpose of the
inquiry is to inform the development of government policies to reduce the issues. Ray (2017),
highlighted that the report adopted the socio-economic model of health and inequalities of health
which traces the root of the health ill determinants (Mohamed‐Ahmed et al. 2016). Therefore,
the reported influenced to highlight the key issues of the target group for designing health
campaign. The reported highlighted that the issue of health inequalities observed in especially
pregnant women because of the social determinants that affected their lifestyle. Accumulated
research highlighted that those pregnant women who have different ethnic and racial background
as well as have lower to the medium socio-economic background are more prone to health
inequalities. Marshall et al. (2016), highlighted that more than 13 % of the pregnant women of

8Health promotion campaign on the smoking cessation during pregnancy
England belong to different ethnic and racial background and experiencing health inequalities.
The prime reason behind it is that due to inadequate knowledge of sexual health and associated
disease, the majority of the women are involved in the unprotected sex (Wilson, Larson and
Paterson 2016). Consequently, get pregnant at a very early age without adequate knowledge of
pregnancy. Jennett et al. (2016), also highlighted that due to lack of knowledge, poor economic
status and partner violence, the majority of the pregnant develop the habit of smoking during
pregnancy out of frustration. Since smoking increases the risk of complications related to
pregnancy, a considered number of pregnant women experience miscarriage, ectopic pregnancy,
placental abruption, and gestational diabetes and low birth weight (Mohamed‐Ahmed et al.
2016). Accumulated evidence suggested that smoke exposure during pregnancy increase the
risk of miscarriage by 11% and in the United Kingdom, 37% of the pregnant women are
suffering from loss fetus every year (Hadley, Ingham and Chandra Mouli 2016). The report
suited to identify that economic status of the pregnant women, education of the women plays a
crucial role in developing complications related to pregnancy (Green, D. and Webb 2016).
Moreover, the report also included identifying that a considerate number of pregnant women are
living in poor household conditions and unaware of prenatal health services that affected their
health (Green and Webb 2016). With the assistance of the report, it was easier to identify the
socioeconomic status of pregnant women and the situation of their households. With the help of
the report, a campaign was designed after identifying the socioeconomic status of the pregnant
women and during the campaign all of the policies which may affect the health in terms of the
health inequalities. To incorporate the pregnant women in the campaign, education regarding
the complications regarding the pregnancy, how health inequalities influenced the complication
and how smoking possibly affected the conditions during pregnancy were given to them (Taylor,
2017). Forgiving education to each pregnant women, in the community hall, each woman was

9Health promotion campaign on the smoking cessation during pregnancy
invited where through PowerPoint presentations and video the adequate knowledge was given to
them and pamphlet was given to each of them for gaining the understanding the complications
regarding pregnant women and the ill effect of smoking habits. For women belong to different
ethnic and racial background, the culturally competent translator was recruited to translate the
information in their langue. After educations, they were involved in different culturally
competent workshops to reduce the habit of smoking and living a healthy life. Additionally, the
report assisted in giving professional or personal guidance for maintaining a healthy lifestyle or
using different tools during the pregnancy (Wilson, Larson and Paterson, 2016).. During the
campaign, the observation of the foetal status health risk associated with the tobacco by-products
to the mother was done by volunteers of the campaign. The report highlighted that a considerate
number of women adopt smoking habits due to their emotional distress during pregnancy
because of poor economic status or pre-pregnancy symptoms which further affected their
wellbeing (Wilson, Larson and Paterson, 2016). Therefore, with the assistance of the report,
specific facilities including financial support were given to the families of pregnant women to
reduce income inequalities and poor household conditions. This facilities significantly reduced
the smoking habits of pregnant women, especially who lived in the disadvantaged area and
developed vigorous smoking habits (Hadley, Ingham and Chandra Mouli 2016). Apart from
these facilities, other facilities such motivational therapies for the mental well-being of them
were given to each pregnant women and their family members to create a supportive
environment within the household and even in the community. It will help to empower the
women and their family members during the pregnancy and create a healthy environment for the
newborn baby. Therefore, the Acheson’s report’ positively influenced to identify the health
inequalities and Rawson behind the health inequalities and designing campaign according to the
campaign. After using the report as a guide for the campaign, it assisted in improved benefit

10Health promotion campaign on the smoking cessation during pregnancy
levels for families with children, reducing the prevalence of smoking during pregnancy, among
others (Hadley, Ingham and Chandra Mouli 2016). Moreover, the health campaign also assists
pregnant women to gain an understanding of the pregnancy and the complications regarding
pregnancy and how smoking can influence it. The campaign also empower each of the women
and give them an opportunity to access to the health care facilities, talk about their concerns to
the volunteers and medical officers and additionally, it also gave them an opportunity to receive
the health care services and develop interpersonal skills and collaboration skills (Wilson, Larson
and Paterson 2016). Therefore, for developing future campaign, this report will assist to show a
positive direction.
Response to Que3:
i. Evaluation of the key health programmes on the theme ‘Reducing smoking among
pregnant women in London’
Health promotion evaluation is done to record a program’s effectiveness and its influence on
assessing quality, cost and the identification of improvement throughout the program. Mainly
an evaluation is processed to check whether the objectives and outcome of the program are
being met or not. To encourage community support and policy decision, a level of
transparency and responsibility from a health promotion evaluation can help to clarify and
guide the implementation of this approach.
Programme evaluation is itself a tough attempt when there is an involvement of evaluation of
behavioural change in an individual such as pregnant women. it is equally important to

11Health promotion campaign on the smoking cessation during pregnancy
identify the approach in behavioural change with the intervention in health promotion. Basic
approaches of this evaluation includes the impact of smoking on both the mother and the
baby, awareness of the possible health related problems with smoking, risk factors such as
morbidity and mortality, change in attitude, change in health condition and life styles.
ii. Different approaches to the health promotion campaign.
To deliver message through television, newspaper or any social platform, mass media
campaign is being widely used for the greater exposure to the population. It is a useful approach
to bring some changes in the health related behaviour with both positive and negative impact on
the population. Basically two theories are based on this mass media campaign approach, which
are social influence and social learning theory. The main strategy of mass media campaign is to
develop the awareness mainly among the young people.
 Educational approach: Knowledge and relevant information about the impact of smoking
on the pregnant women is the key approach. This approach can help to assess the
individual their responsibility on health issues.
 Medical approach: the prime focus of this approach is to track the activity on reducing
morbidity and mortality. This approach values the medical procedures and profession’s
responsibility to ensure the safety of the patient. This approach mainly focuses in the
medical interventions for the prevention of ill health and premature death. This approach
is often criticised for not acknowledging its social and environmental aspects towards
health.

12Health promotion campaign on the smoking cessation during pregnancy
 Behaviour Change approach: the main aim of this approach is to develop a different
attitudes and behaviours for a healthy lifestyles. For example, smoking cessation
programmes.
 Societal change approach: in order to live in a healthy environment, this approach tries to
focus on the improvement required to change the physical, social and economic factors of
the specific environment. The central focus of this approach is on the healthy
environment rather than people who live in it.
C. the six steps of health promotional campaign:
In order to design a successful health promotional campaign, six steps strategies are crucial to
raising awareness for target populations. The first step of health promotional plan manages the
planning process where as the second step of conduct a situational assessment which was done
and the result obtained that the smoking habits of the pregnant women were highlighted as major
issues. The third step is to identify goals, populations of interest. The fourth step is the outcome
to identify strategies, activities, outputs, process. The fifth step develops indicators and the last
step is to review the program plan (Wilson, Larson and Paterson, 2016).. During each step,
accurate planning was done regarding the situations. However, in the third steps, the
sociodemographic status of the women were not taken into considerations and therefore, those
individuals with lower socioeconomic are not able to participate in the campaigns. Therefore, it
is a crucial gap in planning strategy for health promotional campaign. Moreover, no indicators
were taken into consideration during the health promotional plan which is the part of step four.
Therefore, the success of the health promotional plans cannot be measured in this case.
Moreover, considering the interview of the health professionals in this case or other volunteers

13Health promotion campaign on the smoking cessation during pregnancy
along with pregnant women can give a biased result. Therefore, the further accurate plan is
required to accomplish the plan.
 Different resources required for the health promotion campaign and involvement
of various stakeholders.
The different resourses which can be used for this health promotion campaign are badges and
buttons, motivational videos, images and photos, social media content, podcasts and many more.
 Important messages can be dilevered to the campaign website so that visiotors can read
and compell their personal stories of what it’s like to live after quiting smoking.
 Different photos and images can be uploaed by the cancer affected women to prevail the
dangerous and harmful impact of the smoking to the body.
 Resgisted nurses can post their message and opinion of the impact of smoking and its
harmful effct of the fetus and health. Messages can also be delivered by the new
particitants on the health realted issues such as asthama, cancer, Chronic Obstructive
Pulmonary Disease (COPD).they can make success stories of peagant women who quit
smoking (Du Preez, Bendixen, and Abratt, 2017).
 Pamflet and brochiaers can be produced by the community support workers and
different posters can be made by other vollentuess of the progarm to raise awareness
amongst patients.
 Podcasts can also be of great help for a health promotion campaign. This is because it
helps the other women to get acknowlegded with the sufferings of a pregnant women
who used to smoke.
Involvement of different stakeholder for the health promotion campaign.

14Health promotion campaign on the smoking cessation during pregnancy
Involvement of different stakeholder such as individual or any organization is considered
because they can stand to either lose or benefit a process. Basically, a stakeholder can be defined
as a group of individual who can change the prospective of health and financial, can raise an
interest in the health policies, can influence with a innovating decision making and
implementation, can have an outcome out of economic and business interest.
Below is a common list of stakeholders which can be of great help while designing a campaign:
 Community based organizations
 Involvement of residents
 NGOs
 Nurses
 Aid from the family members of the pregnant women
 Individual participation
I. Comparison of the possible impact of the health promotion campaign that
are being carried out either in UK or other country.

15Health promotion campaign on the smoking cessation during pregnancy
Many research has provided evidence that during pregnancy, smoking has the greatest
contributing factors towards the development of many health related issues and risks for both the
baby and the parent. Such campaign is designed for the formative research which could reveal
the limited awareness of the health issues and risks connected with smoking during pregnancy
and some social or personal support to stop such habits (van Zyl and Meiselman, 2015).
Considering the health promotion campaign for raising awareness, the vast differences observed
regarding the impact of health promotions in the United Kingdom and Australia. Considering the
United Kingdoms, the health promotions plans are designed for the one target population to have
near similar ethnicity, race or language they speak. Therefore, the impact of the health
promotions plans is higher in nations like the United Kingdom where the majority of the
individuals has similar cultural and religion believes due to less diverse features. On the other
hand, considering health care promotions campaign of Australia, because of diverse populations
and culture, health promotional plan designed for single target populations cannot be used for the
same target population of different ethnicities. In Australia, the aboriginal populations of the

16Health promotion campaign on the smoking cessation during pregnancy
Torres Strait Islander cover a vast majority of the region and due to lack of health care facilities,
they are suffering from the chronic illness. Newton and Riggs (2016),highlighted that 649,171
people are aboriginal in Australia and 11% of them participate in the health promotion plan.
Consequently, the health promotional campaigns contain different components compared to the
population lives in metropolitan cities. Therefore, the health promotional campaign of
Australia lacks the long term orientations that further increase the cost of conducting the health
promotional campaign compared to the United Kingdom. Moreover, since communication
strategies for the health promotion plans do not require to other languages and cultural believes,
the impact of the health promotions camping in the UK highly effective and it is easier for the
target population to follow the instructions and policies implemented through the health
promotional campaign (Du Preez, Bendixen, and Abratt, 2017). On a contradictory note, it was
highlighted that the cultural believes of the Australia aboriginal individuals are different from the
individuals who live in the metropolitan’s cities. Moreover, they believe in traditional healers or
herbal therapy for reducing any chronic diseases (Desmidt and George, 2016). Therefore, the
impact of health promotions plans is different for the population of metropolitan cities and
different for Aboriginal individuals. The impact of the campaign is less compared to the United
Kingdom since they refuse to accept interventions of health promotions campaigns due to
cultural beliefs. The population of the metropolitans cities greatly influenced by the health
promotions and aboriginal individuals only influenced if specific cultural competencies are
included in the plan.

17Health promotion campaign on the smoking cessation during pregnancy

18Health promotion campaign on the smoking cessation during pregnancy
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