Randomised controlled trial of home based motivational interviewing by midwives to help pregnant smokers quit or cut
D M Tappin1, M A Lumsden, W H Gilmour
1Paediatric 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
Objective:
To determine whether motivational interviewing--a behavioural therapy for addictions-provided at home by specially trained midwives helps pregnant smokers to quit.
Design:
Randomised controlled non-blinded trial analysed by intention to treat.
Setting:
Clinics attached to two maternity hospitals in Glasgow.
Participants:
762/1684 pregnant women who were regular smokers at antenatal booking: 351 in intervention group and 411 in control group.
Interventions:
All women received standard health promotion information. Women in the intervention group were offered motivational interviewing at home. All interviews were recorded.
Main Outcome Measures:
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).
Conclusion:
Good quality motivational interviewing did not significantly increase smoking cessation among pregnant women.
