Researchers in Spain are exploring a novel approach to a persistent public health challenge: smoking cessation among pregnant women. A team at the Universitat Rovira i Virgili (URV) has developed a mobile submission, an adapted version of ‘Tobbstop,’ designed to provide support adn motivation for expectant mothers aiming to quit[[1]]. With approximately 13% of pregnant women in Catalonia, Spain, continuing to smoke through pregnancy, and considering the known risks to both maternal and infant health[[2]], this study investigates whether a gamified app can improve quit rates alongside standard medical advice.
Researchers at the Universitat Rovira i Virgili (URV) in Spain have developed a mobile application designed to help pregnant women quit smoking. The app, an adaptation of a previously created “gamified” mobile tool called ‘Tobbstop,’ aims to provide support during a challenging time for expectant mothers.
Approximately 13% of pregnant women in Catalonia, Spain, who smoke are unable to quit during their pregnancy, highlighting a significant public health concern. Smoking during pregnancy carries substantial risks for both mother and baby, and this new tool seeks to address that challenge.
Lead researcher Cristina Rey explains that the application functions as “a game to help in a complex process” like smoking cessation. The app includes games designed to “entertain” users during moments of “maximum anxiety or unease to smoke,” alongside monitoring of their progress.
Currently, a community trial involving 105 women is underway, comparing the effectiveness of the app to standard cessation advice provided by healthcare professionals. Researchers at URV hope to determine if the app can improve quit rates among pregnant women.
The app provides users with access to informational resources, videos, and recommendations for quitting smoking. It also features a “panic button” offering relaxation exercises for moments of intense craving.
Increased Risks During Childbirth
Rey emphasizes the serious health implications of smoking, particularly for pregnant women. “There is considerable evidence determining that pregnant women who smoke have more risks to themselves during childbirth, as well as to their babies at birth and during the first years of life,” she said. These findings underscore the importance of smoking cessation interventions during pregnancy.
The study, which has been recognized by the Official College of Nurses and Midwives of Tarragona, is ongoing, but preliminary results are already emerging.
Researchers have observed that smoking during pregnancy increases the risk of dystocic and premature labor. Dystocic labor, characterized by difficult or obstructed labor, often requires instrumental intervention – such as forceps, vacuum extraction, or cesarean section – during delivery.
Preliminary data indicates that 46.2% of participants in the study experienced a dystocic labor, nearly double the rate observed in the general population. Additionally, 20.9% of births were premature, a rate three times higher than the national average (INE data, 2023).
Underdiagnosis Due to Social Stigma
Researchers note that numerous health-focused applications are available, but the success of smoking cessation often hinges on sustained engagement. “The process of quitting smoking is very complex and gamification is a tool that can increase success rates,” Rey stated. She added that “evidence tells us that people have to try many times before succeeding,” and the app can be a valuable tool to maintain motivation.
Maria Agras, a physician at the CAP Llibertat de Reus and a doctoral candidate at URV, points out that pregnant women represent a “vulnerable population.” She also explains that smoking is often “underdiagnosed” among pregnant women because they are reluctant to disclose their habit.
“They are ashamed, and there is a significant social stigma,” Agras said. She stresses that healthcare professionals “must insist” on screening during primary care visits to detect cases and “initiate prevention as soon as possible.”
Regarding the proliferation of health apps, Agras emphasizes the importance of verifying their validation. “Not everything works,” she cautions, recommending those with the strongest “evidence base.” Researchers are currently evaluating whether ‘Tobbstop’ is beneficial for the broader population.
Agras concludes that anyone wanting to quit smoking should seek support from primary care, where nurses provide ongoing follow-up and guidance.
