Randomised controlled trial of home based motivational interviewing by midwives to help pregnant smokers quit or cut down.
OBJECTIVE
To determine whether motivational interviewing--a behavioural therapy for addictions-provided at home by specially trained midwives helps pregnant smokers to quit.


METHODS
Randomised controlled non-blinded trial analysed by intention to treat.


METHODS
Clinics attached to two maternity hospitals in Glasgow.


METHODS
762/1684 pregnant women who were regular smokers at antenatal booking: 351 in intervention group and 411 in control group.


METHODS
All women received standard health promotion information. Women in the intervention group were offered motivational interviewing at home. All interviews were recorded.


METHODS
Self reported smoking cessation verified by plasma or salivary cotinine concentration.


RESULTS
17/351 (4.8%) women in the intervention group stopped smoking (according to self report and serum cotinine concentration < 13.7 ng/ml) compared with 19/411(4.6%) in the control group. Fifteen (4.2%) women in the intervention group cut down (self report and cotinine concentration less than half that at booking) compared with 26 (6.3%) in the control group. Fewer women in the intervention group reported smoking more (18 (5.1%) v 44 (10.7%); relative risk 0.48, 95% confidence interval 0.28 to 0.81). Birth weight did not differ significantly (mean 3078 g v 3048 g).


CONCLUSIONS
Good quality motivational interviewing did not significantly increase smoking cessation among pregnant women.
Tappin
D M
DM
Paediatric Epidemiology and Community Health Unit, Department of Child Health, Division of Developmental Medicine, University of Glasgow, Yorkhill, Glasgow G3 8SJ. goda11@udcf.gla.ac.uk
Lumsden
M A
MA
Gilmour
W H
WH
Crawford
F
F
McIntyre
D
D
Stone
D H
DH
Webber
R
R
MacIndoe
S
S
Mohammed
E
E
D000328:Adult; D003367:Cotinine / Q000032:analysis; D003376:Counseling / Q000379:methods*; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008880:Midwifery / Q000379:methods*; D009042:Motivation; D010349:Patient Compliance; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D012463:Saliva / Q000737:chemistry; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D000074606:Smoking Prevention; D016896:Treatment Outcome
D003367:Cotinine