Hegaard Hanne K, Kjaergaard Hanne, Møller Lars F, Wachmann Henrik, Ottesen Bent
Department of Obstetrics and Gynecology, Hvidovre Hospital, Copenhagen Hospital Corporation, Copenhagen University Hospital, Denmark.
Acta Obstet Gynecol Scand. 2003 Sep;82(9):813-9. doi: 10.1034/j.1600-0412.2003.00221.x.
The aim was to study the effect of a multimodal smoking cessation intervention regimen on a number of pregnant smokers.
A prospective intervention study was designed where participants were allocated to intervention or control based on their birth date. The study included 647 pregnant smokers. The intervention group (n = 327) received initial individual smoking cessation counseling supplemented by an invitation to join, individually or in a group, a smoking cessation program with nicotine replacement therapy as a voluntary option. Intervention was designed as an integral part of the midwives' prenatal care. All pregnant smokers in the usual care group (n = 320) received standard counseling from a midwife. Outcome was self-reported smoking cessation in the 37th week of pregnancy and the reported cessation was validated by cotinine saliva concentration.
Self-reported cessation rates during pregnancy were significantly higher in the intervention group (14%) than in the group receiving usual care (5.0%) (p < 0.0001) (Fisher's exact test). Cotinine-validated cessation rates during pregnancy were significantly higher among the former (7%) than the latter (2%) (p = 0.003). The adjusted odds ratio (OR) for smoking cessation was 4.20 (95% CI 2.13-8.03). Logistic regression analysis showed a significant positive association of smoking cessation with low caffeine consumption in pregnancy, many years in school, no exposure to passive smoking outside the home, and previous attempts to stop smoking.
A multimodal intervention regimen with initial individual counseling supplemented by an invitation to join a smoking cessation program with nicotine replacement therapy as a voluntary option markedly increased cessation rates during pregnancy.
本研究旨在探讨多模式戒烟干预方案对众多孕期吸烟女性的影响。
设计一项前瞻性干预研究，根据参与者的出生日期将其分为干预组或对照组。该研究纳入了647名孕期吸烟女性。干预组（n = 327）首先接受个体化戒烟咨询，并受邀单独或分组参加一个包含尼古丁替代疗法的戒烟项目（可自愿选择）。干预措施被设计为助产士产前护理的一个组成部分。常规护理组的所有孕期吸烟女性（n = 320）接受助产士提供的标准咨询。观察指标为孕期第37周时自我报告的戒烟情况，且报告的戒烟情况通过唾液可替宁浓度进行验证。
干预组孕期自我报告的戒烟率（14%）显著高于接受常规护理的组（5.0%）（p < 0.0001）（Fisher精确检验）。干预组孕期经可替宁验证的戒烟率（7%）显著高于常规护理组（2%）（p = 0.003）。戒烟的校正比值比（OR）为4.20（95%CI 2.13 - 8.03）。逻辑回归分析显示，孕期低咖啡因摄入量、受教育年限长、在家中无被动吸烟暴露以及既往有戒烟尝试与戒烟存在显著正相关。
一种多模式干预方案，即首先进行个体化咨询，并受邀参加一个包含尼古丁替代疗法的戒烟项目（可自愿选择），显著提高了孕期戒烟率。
