Abstract
BackgroundSmoking cessation interventions in pregnancy could influence a woman's social behaviour and her partner's smoking behaviour, but this has not been examined in any published randomized trials.Method918 women smoking at booking for antenatal care were enrolled in a cluster-randomized trial of three interventions: standard care, self-help manual and enhanced stage-based counselling, or self-help manual, enhanced stage-based counselling and use of an interactive computer program. The outcomes were change in social support received by women between booking for maternity care and 30 weeks gestation and 10 days postpartum and reported cessation in the woman's partner at these times.ResultsFew pregnant women's partners stopped smoking (4.1% at 30 weeks of gestation and 5.8% at 10 days postpartum) and the probability of quitting did not differ significantly by trial arm. Women's scores on the Inventory of Socially Supportive Behaviors showed a slight decline from booking to 30 weeks gestation, and a slight increase to 10 days postpartum, but these changes did not differ significantly by trial arm.ConclusionThe stage-based interventions tested in this trial aimed partly to influence women's mobilization of support and might have influenced partners' quitting, but there was no evidence that they did so. Given that women and their partners often stopped smoking together, future interventions to prevent smoking in pregnant women could encourage both partners to quit together.
Highlights
Smoking cessation interventions in pregnancy could influence a woman's social behaviour and her partner's smoking behaviour, but this has not been examined in any published randomized trials
The authors of the Cochrane review suggest that future studies of smoking cessation in pregnancy record the effects on family functioning, meaning a basket of social and emotional outcomes
In a comment on the Cochrane review of smoking cessation interventions in pregnancy[1], Oliver contrasts it with another Cochrane review[2], which evaluated the outcomes of social support for disadvantaged mothers on maternal and child well being[3]
Summary
Smoking cessation interventions in pregnancy could influence a woman's social behaviour and her partner's smoking behaviour, but this has not been examined in any published randomized trials. Given that nicotine dependence and smoking in pregnancy is embedded within socio-economic disadvantage to such a degree, we might expect that both sets of studies within the Cochrane reviews to have a similar range of broad outcomes This is only true for those studies where the intervention was social support and not for those studies examining smoking cessation advice in pregnancy. People who stop smoking are on average less stressed than when they were smoking[9] This is the report of one trial of smoking cessation advice in pregnancy and its influence on two disparate secondary outcome measures that reflect family functioning. These are partners quitting and the social support given to the pregnant woman
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