利用产后住院时间解决母亲和父亲的吸烟问题:NEWS 研究。

Using the postpartum hospital stay to address mothers' and fathers' smoking: the NEWS study.

机构信息

MGH Center for Child and Adolescent Health Policy, 50 Staniford St, Suite #901, Boston, MA 02114, USA.

出版信息

Pediatrics. 2010 Mar;125(3):518-25. doi: 10.1542/peds.2009-0356. Epub 2010 Feb 1.

Abstract

OBJECTIVE

The objective of this study was to test the feasibility and acceptability of introducing an intervention to address mothers' and fathers' smoking during the postpartum hospitalization.

METHODS

During a 14-month period (February 2005 to April 2006), we assessed the smoking status of both parents of all newborns who were delivered at a hospital child birth center. Parents who were current smokers (1 cigarette, even a puff, in past 30 days) or recent quitters (smoked since 1 month before conception) were eligible for the study. Parents were assigned to intervention or usual care control condition on the basis of day of study enrollment. Smoking outcomes were assessed at 3 months by telephone survey and cotinine confirmation; quitline use was assessed at 3 months by using quitline database.

RESULTS

A total of 101 (64%) of 159 eligible parents enrolled in the study (n = 53 control subject, n = 48 intervention), including 72 (71%) current smokers and 29 (29%) recent quitters. All parents in the intervention group received the in-hospital counseling session, 94% had a fax sent to a provider, and 36 (75%) accepted quitline enrollment. In an intention-to-treat analysis that included both current smokers and recent quitters, self-reported 7-day abstinence decreased from 31% to 25% among intervention parents versus 38% to 23% among control subjects (effect size 9.4%; nonsignificant). Among current smokers at baseline who were reached at follow-up (n = 36), self-reported 24-hour quit attempts were higher in the intervention group versus control group (64% vs 18%; P = .005), whereas the cotinine-confirmed 7-day abstinence rates at follow-up were 9% in the intervention group and 3% in the control group (nonsignificant).

CONCLUSIONS

Enrolling mothers and fathers into tobacco treatment services during the immediate postpartum hospital stay is feasible and seems to stimulate quit attempts. The birth of an infant presents a teachable moment to reach both parents and to provide cessation assistance.

摘要

目的

本研究旨在测试在产后住院期间引入干预措施以解决母亲和父亲吸烟问题的可行性和可接受性。

方法

在 14 个月的时间内(2005 年 2 月至 2006 年 4 月),我们评估了在医院分娩中心分娩的所有新生儿的父母的吸烟状况。目前吸烟(过去 30 天内吸过 1 支烟,甚至吸过 1 口烟)或最近戒烟者(在受孕前 1 个月内吸烟)的父母符合研究条件。根据研究登记日,父母被分配到干预或常规护理对照组。通过电话调查和可替宁确认在 3 个月时评估吸烟结果;通过使用戒烟热线数据库在 3 个月时评估戒烟热线使用情况。

结果

共有 159 名符合条件的父母中的 101 名(64%)参加了研究(n=53 名对照组,n=48 名干预组),包括 72 名(71%)目前吸烟者和 29 名(29%)最近戒烟者。干预组的所有父母都接受了住院咨询,94%的父母收到了给医生的传真,36 名(75%)接受了戒烟热线登记。在包括目前吸烟者和最近戒烟者的意向治疗分析中,与对照组相比,干预组父母的自我报告 7 天戒烟率从 31%下降至 25%(效应大小 9.4%;无统计学意义)。在基线时为目前吸烟者且在随访时可联系到的 36 名参与者中,干预组的 24 小时戒烟尝试率高于对照组(64% vs 18%;P=0.005),而在随访时,干预组的可替宁确认的 7 天戒烟率为 9%,对照组为 3%(无统计学意义)。

结论

在产后住院期间将母亲和父亲纳入烟草治疗服务是可行的,并且似乎可以刺激戒烟尝试。婴儿的出生为接触父母并提供戒烟帮助提供了一个可教的时刻。

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