Indigenous Maternal and Child Health Research Program, Baker IDI Heart and Diabetes Institute, Melbourne, VIC.
Med J Aust. 2012 Jul 2;197(1):42-6. doi: 10.5694/mja11.10858.
To determine the effectiveness of an intensive quit-smoking intervention on smoking rates at 36 weeks' gestation among pregnant Aboriginal and Torres Strait Islander women.
Randomised controlled trial.
Pregnant Aboriginal and Torres Strait Islander women (n = 263) attending their first antenatal visit at one of three Aboriginal community-controlled health services between June 2005 and December 2009.
A general practitioner and other health care workers delivered tailored advice and support to quit smoking to women at their first antenatal visit, using evidence-based communication skills and engaging the woman's partner and other adults in supporting the quit attempts. Nicotine replacement therapy was offered after two failed attempts to quit. The control ("usual care") group received advice to quit smoking and further support and advice by the GP at scheduled antenatal visits.
Self-reported smoking status (validated with a urine cotinine measurement) between 36 weeks' gestation and delivery.
Participants in the intervention group (n = 148) and usual care group (n = 115) were similar in baseline characteristics, except that there were more women who had recently quit smoking in the intervention group than the control group. At 36 weeks, there was no significant difference between smoking rates in the intervention group (89%) and the usual care group (95%) (risk ratio for smoking in the intervention group relative to usual care group, 0.93 [95% CI, 0.86-1.08]; P = 0.212). Smoking rates in the two groups remained similar when baseline recent quitters were excluded from the analysis.
An intensive quit-smoking intervention was no more effective than usual care in assisting pregnant Aboriginal and Torres Strait Islander women to quit smoking during pregnancy. Contamination of the intervention across groups, or the nature of the intervention itself, may have contributed to this result.
Australian New Zealand Clinical Trials Registry ACTRN12609000929202.
确定强化戒烟干预措施对 36 孕周妊娠的土著和托雷斯海峡岛民孕妇吸烟率的影响。
随机对照试验。
2005 年 6 月至 2009 年 12 月期间，在三家土著社区控制的医疗服务机构中的一家参加首次产前检查的土著和托雷斯海峡岛民孕妇（n=263）。
全科医生和其他卫生保健工作者在孕妇的首次产前检查时，使用基于证据的沟通技巧，让孕妇的伴侣和其他成年人参与到支持戒烟的尝试中来，为其提供量身定制的戒烟建议和支持。在两次戒烟尝试失败后，提供尼古丁替代疗法。对照组（“常规护理”）组在预定的产前访视中接受戒烟建议和进一步的支持和建议。
36 孕周妊娠至分娩期间自我报告的吸烟状况（通过尿液可替宁测量进行验证）。
干预组（n=148）和常规护理组（n=115）的参与者在基线特征方面相似，除了干预组中最近戒烟的女性多于对照组。在 36 孕周时，干预组（89%）和常规护理组（95%）的吸烟率之间没有显著差异（干预组相对于常规护理组的吸烟风险比，0.93[95%CI，0.86-1.08]；P=0.212）。当从分析中排除基线最近戒烟者时，两组的吸烟率仍然相似。
强化戒烟干预措施与常规护理相比，在帮助土著和托雷斯海峡岛民孕妇在怀孕期间戒烟方面没有更有效。干预组之间的交叉污染或干预本身的性质可能导致了这一结果。
澳大利亚新西兰临床试验注册中心 ACTRN12609000929202。
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