Smoking and contraception containing ethinylestradiol: A mixed-methods study into women’s intentions to quit smoking

Background: Smoking while using contraception containing ethinylestradiol increases the risk of cardiovascular diseases. Therefore, it is especially important to stimulate women who use these contraceptives to quit smoking. Objectives: This study aimed to examine the role of risk perception and coping in relation to the intention of these women to quit smoking, using the Protection Motivation Theory as the theoretical foundation. Design: This was an explanatory sequential mixed-methods design. Methods: An online survey (n = 68) was used to examine the relationship among risk perception, coping assessment, and intention to quit smoking. After that 15 in-depth semi-structured interviews were conducted to understand how women appraised risk and coping strategies during their quit attempt(s). Results: Results from the survey showed that risk perception induces the intention to quit smoking. More specifically, perceived vulnerability appeared to be a significant predictor. The interviews showed that women were largely unfamiliar with the combined risks surrounding smoking and contraception use but acknowledged the risks of smoking. In the survey, women seemed to perceive themselves as self-efficacious. However, interview participants mentioned that they encountered many difficulties. Conclusion: Based on these findings, we conclude women are largely unaware of the synergetic risk of contraception use and smoking. Stimulating risk perception and knowledge might help women to create the intention to quit smoking. However, to turn this intention into behavior, providing women with concrete tools to assist them might successfully sustain their quit attempt.