Use of Social Media Tools to Reach and Engage Pregnant Smokers

Background:  Pregnant women are an important target for smoking cessation interventions. Smoking during pregnancy presents major, avoidable health risks to both the woman and fetus. Despite ongoing public health efforts, smoking prevalence among pregnant women remains alarmingly high.

Program background:  Emerging internet technologies (i.e., social media) may enhance outreach efforts; however, the optimal parameters for leveraging social media tools to reach and engage pregnant smokers in cessation efforts have yet to be established. The current study had two complementary aims: 1) to describe the internet presence of pregnant smokers on social networking sites, in order to better understand how they interact with social media; and 2) to determine the effectiveness of social media outreach activities aimed at pregnant smokers.

Evaluation Methods and Results: To accomplish the first aim, we conducted an environmental scan of content on social networking sites targeting pregnant women, including smokers. The scan revealed an abundance of user-generated posts containing misinformation regarding smoking health risks and cessation methods. Additionally, pregnant smokers who requested help in online communities were frequently met with unsupportive comments and personal attacks by nonsmokers. Lastly, there was a consistent presence across social networking sites of a subgroup of pregnant smokers who were highly resistant to quitting, represented by forums with names like “Yes! I smoke!!” and “Smoking Mommies”. These findings informed our second aim, in which we conducted strategic outreach activities aimed at pregnant smokers, across five social media platforms (i.e., Facebook, MySpace, CaféMom, Twitter, Ning). Outreach activities took two forms: 1) broadcasting information and resources related to smoking cessation; and, 2) providing targeted cessation support via conversations in online communities. Web analytics measured how effectively the sites engaged users with online smoking cessation content. Broadcast outreach activities resulted in increased visibility and propagation of smoking cessation content in pregnant smokers’ social networks. Twitter and Facebook emerged as the most active and visible platforms. A total of 353 “tweets” were broadcast to 364 followers; “retweets” and “@mentions” increased penetration to approximately 8100 followers. Facebook had fewer total users than Twitter, but greater socio-ecological reach; nearly half of the 100 posts broadcast on Facebook were referred to users’ online networks as “likes”, comments, or posts. Targeted cessation support outreach activities via CaféMom resulted in 19 online conversation threads with pregnant smokers who were seeking information and cessation support. These conversations generated 9166 page views and yielded a high post-to-impression ratio.

Conclusions: Results suggest that pregnant smokers have a significant presence on social networking sites, and are eager to engage in conversations around smoking. The findings also highlight the need to minimize misinformation about smoking cessation in these forums, and the importance of creating a supportive environment for pregnant women trying to quit. To that end, outreach activities designed to cultivate greater support within online forums are currently underway, including the development of targeted and shareable materials.

Implications for research and/or practice: Social media platforms can be effectively leveraged to broadcast information and resources to pregnant smokers’ online social networks, and to provide targeted cessation support.