The effects of smoking cessation counseling by midwives on Dutch pregnant women and their partners.

OBJECTIVE

Smoking during pregnancy is an important problem in the Netherlands. We tested the effectiveness of a health counseling method by midwives using a RCT.

METHODS

Four provinces with 42 practices including 118 midwives were randomly assigned to the experimental or control condition. Midwives in the experimental group provided brief health counseling, self-help materials on smoking cessation during pregnancy and early postpartum, and a partner booklet. Controls received routine care. The main outcome measures were 7-day abstinence, continuous abstinence, and partner smoking at 6 weeks post-intervention (T1) and 6 weeks postpartum (T2).

RESULTS

Multi-level analysis revealed significant differences between both conditions at T1 and T2 using intention-to-treat analysis. Nineteen percent of the experimental group reported 7-day abstinence compared to 7% of the control group at T1, and 21 and 12%, respectively, at T2. For continuous abstinence these percentages were 12% in the experimental group and 3% in the control group. The partner intervention was not successful.

CONCLUSION

The intervention resulted in significant effects on smoking behavior for pregnant women, but not for partner smoking.

PRACTICE IMPLICATIONS

The program realized short-term effects. An important precondition is that midwives need a proper training.