Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.
Research Institute on Addictions, State University of New York at Buffalo, Buffalo, NY, USA.
Transl Behav Med. 2019 Mar 1;9(2):308-318. doi: 10.1093/tbm/iby027.
Given serious consequences of maternal smoking, we aimed to develop and test a multicomponent behavioral intervention to enhance smoking cessation during pregnancy. In this nonconcurrent, multiple-baseline intervention pilot study, 48 daily smoking pregnant women (mean 13.7 weeks of gestation) were recruited from Buffalo, NY, USA. Upon completion of the repeated baseline smoking monitoring (up to 3 weeks), 30 continuous smokers received a contingent financial incentive-based intervention with three additional components (education and counseling, monitoring and feedback, and family support). After the quit date, participants met with counselors (~1 hr/visit) daily for 2 weeks and twice a week for another 6 weeks. Twenty-one out of 30 participants quit smoking completely (verified by urine cotinine) after receiving the intervention, and the other nine nonquitters decreased smoking substantially. The estimated smoking cessation rate was 70.0% (21/30) at the second week of the intervention, and 63.3% (19/30) at the conclusion of the 8-week intervention assuming the dropouts as smoking. In interrupted time series analysis, the mean daily number of cigarettes smoked among quitters decreased by 6.52, 5.34, and 4.67 among early, delayed, and late intervention groups, respectively. Quitters' mean urine cotinine level maintained stably high before the intervention but decreased rapidly to the nonsmoking range once the intervention was initiated. Most participants (85.7%) reported meeting or exceeding expectations, and 100% would recommend the program to others. This pilot multicomponent intervention was feasible and acceptable to most participants, resulting in a high smoking cessation rate among pregnant smokers who were unlikely to quit spontaneously.
鉴于母亲吸烟会产生严重后果，我们旨在开发和测试一种多成分行为干预措施，以增强孕妇怀孕期间的戒烟效果。在这项非同期、多基线干预性先导研究中，我们从美国纽约州布法罗招募了 48 名每日吸烟的孕妇（平均妊娠 13.7 周）。在完成重复的基线吸烟监测（最长 3 周）后，30 名连续吸烟者接受了有三个附加成分（教育和咨询、监测和反馈、家庭支持）的基于 contingent financial incentive 的干预措施。在戒烟日期后，参与者与顾问每天见面（每次约 1 小时），持续 2 周，然后每周见面两次，持续 6 周。在接受干预后，30 名参与者中有 21 名完全戒烟（通过尿液可替宁验证），其他 9 名非戒烟者则大幅减少了吸烟量。在干预的第二周，估计戒烟率为 70.0%（21/30），在 8 周干预结束时，假设辍学者仍在吸烟，戒烟率为 63.3%（19/30）。在中断时间序列分析中，戒烟者的平均每日吸烟量分别减少了 6.52、5.34 和 4.67，分别为早期、延迟和晚期干预组。戒烟者的平均尿液可替宁水平在干预前保持稳定高值，但一旦干预开始，迅速下降至非吸烟范围。大多数参与者（85.7%）报告满足或超过预期，100%会向他人推荐该计划。这项多成分干预性先导研究对于大多数参与者来说是可行和可接受的，导致不太可能自发戒烟的孕妇吸烟人群的戒烟率很高。
