Angela L Stotts1, Thomas F Northrup1, Charles Green2, Robert Suchting3, Melbourne F Hovell4, Amir Khan2, Yolanda R Villarreal1, Joy M Schmitz3, Mary M Velasquez5, S Katharine Hammond6, Eunha Hoh7, Jon Tyson2. 1. Department of Family and Community Medicine, McGovern Medical School at UTHealth, Houston, TX. 2. Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX. 3. Department of Psychiatry and Behavioral Science, McGovern Medical School at UTHealth, Houston, TX. 4. Center for Behavioral Epidemiology and Community Health, School of Public Health, San Diego State University, San Diego, CA. 5. School of Social Work, University of Texas, Austin, TX. 6. Division of Environmental Health, School of Public Health, University of California, Berkeley, CA. 7. Division of Environmental Health, School of Public Health, San Diego State University, San Diego, CA.
Abstract
OBJECTIVE: To evaluate a hospital-initiated intervention to reduce tobacco smoke exposure in infants in the neonatal intensive care unit. STUDY DESIGN: A randomized, controlled trial compared motivational interviewing plus financial incentives with conventional care on infant urine cotinine at 1 and 4 months' follow-up. Mothers of infants in the neonatal intensive care unit (N = 360) who reported a smoker living in the home were enrolled. Motivational interviewing sessions were delivered in both the hospital and the home. Financial incentives followed session attendance and negative infant cotinine tests postdischarge. RESULTS: The intervention effect on infant cotinine was not significant, except among mothers who reported high baseline readiness/ability to protect their infant (P ≤ .01) and mothers who completed the study within 6 months postdischarge (per protocol; P ≤ .05). Fewer mothers in the motivational interviewing plus financial incentives condition were smoking postdischarge (P ≤ .01). More mothers in the motivational interviewing plus financial incentives group reported a total home and car smoking ban at follow-up (P ≤ .05). CONCLUSIONS:Motivational interviewing combined with financial incentivesreduced infant tobacco smoke exposure in a subset of women who were ready/able to protect their infant. The intervention also resulted in less maternal smoking postpartum. More robust interventions that include maternal and partner/household smoking cessation are likely needed to reduce the costly effects of tobacco smoke exposure on children and their families. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01726062.
RCT Entities:
OBJECTIVE: To evaluate a hospital-initiated intervention to reduce tobacco smoke exposure in infants in the neonatal intensive care unit. STUDY DESIGN: A randomized, controlled trial compared motivational interviewing plus financial incentives with conventional care on infant urine cotinine at 1 and 4 months' follow-up. Mothers of infants in the neonatal intensive care unit (N = 360) who reported a smoker living in the home were enrolled. Motivational interviewing sessions were delivered in both the hospital and the home. Financial incentives followed session attendance and negative infantcotinine tests postdischarge. RESULTS: The intervention effect on infantcotinine was not significant, except among mothers who reported high baseline readiness/ability to protect their infant (P ≤ .01) and mothers who completed the study within 6 months postdischarge (per protocol; P ≤ .05). Fewer mothers in the motivational interviewing plus financial incentives condition were smoking postdischarge (P ≤ .01). More mothers in the motivational interviewing plus financial incentives group reported a total home and car smoking ban at follow-up (P ≤ .05). CONCLUSIONS: Motivational interviewing combined with financial incentives reduced infanttobacco smoke exposure in a subset of women who were ready/able to protect their infant. The intervention also resulted in less maternal smoking postpartum. More robust interventions that include maternal and partner/household smoking cessation are likely needed to reduce the costly effects of tobacco smoke exposure on children and their families. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01726062.
Authors: Thomas F Northrup; Angela L Stotts; Robert Suchting; Amir M Khan; Charles Green; Michelle R Klawans; Penelope J E Quintana; Eunha Hoh; Melbourne F Hovell; Georg E Matt Journal: Nicotine Tob Res Date: 2021-01-22 Impact factor: 4.244
Authors: Charlotta Pisinger; Cecilie Goltermann Toxværd; Mette Rasmussen Journal: Int J Environ Res Public Health Date: 2022-08-31 Impact factor: 4.614
Authors: Thomas F Northrup; Robert Suchting; Charles Green; Amir Khan; Michelle R Klawans; Angela L Stotts Journal: Pediatr Res Date: 2020-09-16 Impact factor: 3.756
Authors: Caitlin Notley; Tracey J Brown; Linda Bauld; Elaine M Boyle; Paul Clarke; Wendy Hardeman; Richard Holland; Marie Hubbard; Felix Naughton; Amy Nichols; Sophie Orton; Michael Ussher; Emma Ward Journal: Int J Environ Res Public Health Date: 2022-03-19 Impact factor: 3.390