Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Linda Robinson, PhD, RN, Chair; Louise M. Rauckhorst, RN, EdD, FAAN; Major L. King, PhD, RN


Ajzen's Theory of Planned Behavior, cigarette smoking, military healthcare system, nursing, Postpartum Smoking Questionnaire, women


Cigarette smoking is the leading preventable cause of death in the United States. Smoking also accounts for significant morbidity for others exposed to environmental tobacco smoke. Many women stop smoking during pregnancy. Most women relapse to smoking following delivery, yet postpartum smoking issues have received little attention. The purpose of this study was to develop and test an instrument, the Postpartum Smoking Questionnaire (PPSQ) using Ajzen's Theory of Planned Behavior. The belief-based items of the PPSR-Q were developed following content analysis of 35 individual, structured elicitation study interviews with postpartum women in the military healthcare system. Beliefs that prevented women from smoking included: worrying about the health of family members due to one's own smoking, wanting to be a positive role model for children, and wanting to live longer. Stress management, addiction, and getting a break from the baby were reported as modal beliefs that contributed to postpartum smoking. Pilot testing of the PPSR-Q was conducted using test-retest reliability and item-to-total score correlation techniques. Suggested nursing interventions are presented based on the elicitation study results. Following further development and psychometric testing, the PPSQ will be used to guide the development, implementation, and evaluation of effective, targeted behavioral interventions that will reduce postpartum smoking rates.

Document Type

Dissertation: Open Access



Included in

Nursing Commons