School of Nursing, University of Hong Kong, Hong Kong, China.
Shenzhen hospital, Southern Medical University, Shenzhen, China.
PLoS Med. 2020 Sep 29;17(9):e1003355. doi: 10.1371/journal.pmed.1003355. eCollection 2020 Sep.
Secondhand smoke can cause adverse pregnancy outcomes, yet there is a lack of effective smoking cessation interventions targeted at expectant fathers. We examined the effectiveness of a video-based smoking cessation intervention focusing on maternal and child health in promoting quitting among expectant fathers.
A single-blind, 3-arm, randomized controlled trial was conducted at the obstetrics registration centers of 3 tertiary public hospitals in 3 major cities (Guangzhou, Shenzhen, and Foshan) in China. Smoking expectant fathers who registered with their pregnant partners were invited to participate in this study. Between 14 August 2017 to 28 February 2018, 1,023 participants were randomized to a video (n = 333), text (n = 322), or control (n = 368) group. The video and text groups received videos or text messages on the risks of smoking for maternal and child health via instant messaging. The control group received a leaflet with information on smoking cessation. Follow-up visits were conducted at 1 week and at 1, 3, and 6 months. The primary outcome, by intention to treat (ITT), was validated abstinence from smoking at the 6-month follow-up. The secondary outcomes included 7-day point prevalence of abstinence (PPA) and level of readiness to quit at each follow-up. The mean age of participants was 32 years, and about half of them were first-time expectant fathers. About two-thirds of participants had completed tertiary education. The response rate was 79.7% (815 of 1,023) at 6 months. The video and text groups had higher rates of validated abstinence than the control group (video group: 22.5% [75 of 333], P < 0.001; text group: 14.9% [48 of 322], P = 0.02; control group: 9.2% [34 of 368]) with adjusted odds ratios (ORs) of 2.80 (95% confidence interval [CI]: 1.79-4.37, P < 0.001) in the video group and 1.70 (95% CI: 1.06-2.74, P = 0.03) in the text group. The video and text groups differed in the rates of validated abstinence (22.5% versus 14.9%, P = 0.008; adjusted OR: 1.64, 95% CI: 1.10-2.46, P = 0.02). The video and text groups had higher rates of 7-day PPA than the control group at 6 months (video group: 24.6% [82 of 333] versus 11.4% [42 of 368], P < 0.001; text group: 17.4% [56 of 333] versus 11.4% [42 of 368], P = 0.02). The video and text groups also differed in the rates of 7-day PPA (24.6% versus 17.4%, P = 0.02). Excluding the quitters, the video and text groups had higher levels of readiness to quit than the control group at 6 months (video group: 43.5% [109 of 251] versus 31.6% [103 of 326], P = 0.002; text group: 40.6% [108 of 266] versus 31.6% [103 of 326], P = 0.01), No such difference was detected between the video and text groups (43.5% versus 40.6%, P = 0.29). The study was limited in that the long-term effectiveness of the intervention is uncertain.
This smoking cessation intervention for expectant fathers that focused on explaining the ramifications of smoking on maternal and child health was effective and feasible in promoting quitting, and video messages were more effective than texts in delivering the information.
ClinicalTrials.gov: NCT03236025.
二手烟可导致不良妊娠结局，但针对准父亲的有效戒烟干预措施仍十分匮乏。我们旨在研究以母婴健康为重点的基于视频的戒烟干预措施对促进准父亲戒烟的效果。
这是一项在中国 3 个大城市（广州、深圳和佛山）的 3 家三级公立医院的产科登记中心进行的单盲、3 臂、随机对照试验。我们邀请登记了伴侣妊娠的吸烟准父亲参与本研究。2017 年 8 月 14 日至 2018 年 2 月 28 日，1023 名参与者被随机分为视频组（n=333）、短信组（n=322）或对照组（n=368）。视频组和短信组通过即时消息接收到有关母婴健康的吸烟风险的视频或短信。对照组则收到了一份关于戒烟的传单。在 1 周和 1、3、6 个月进行随访。主要结局（意向治疗，ITT）为 6 个月时验证的戒烟率。次要结局包括每个随访时的 7 天点戒烟率（PPA）和戒烟准备程度。参与者的平均年龄为 32 岁，约一半为首次准父亲。约三分之二的参与者完成了高等教育。6 个月时的应答率为 79.7%（815/1,023）。视频组和短信组的验证戒烟率高于对照组（视频组：22.5%[75/333]，P<0.001；短信组：14.9%[48/322]，P=0.02；对照组：9.2%[34/368]），调整后的优势比（OR）分别为 2.80（95%置信区间[CI]：1.79-4.37，P<0.001）和 1.70（95% CI：1.06-2.74，P=0.03）。视频组和短信组之间的验证戒烟率也存在差异（22.5%与 14.9%，P=0.008；调整后的 OR：1.64，95% CI：1.10-2.46，P=0.02）。视频组和短信组在 6 个月时的 7 天 PPA 高于对照组（视频组：24.6%[82/333]与 11.4%[42/368]，P<0.001；短信组：17.4%[56/333]与 11.4%[42/368]，P=0.02）。视频组和短信组之间的 7 天 PPA 也存在差异（24.6%与 17.4%，P=0.02）。排除戒烟者后，视频组和短信组在 6 个月时的戒烟准备程度高于对照组（视频组：43.5%[109/251]与 31.6%[103/326]，P=0.002；短信组：40.6%[108/266]与 31.6%[103/326]，P=0.01），但在视频组和短信组之间未检测到差异（43.5%与 40.6%，P=0.29）。该研究存在一定局限性，干预措施的长期效果尚不确定。
该以母婴健康为重点的准父亲戒烟干预措施在促进戒烟方面是有效和可行的，且视频信息比短信更有效。
ClinicalTrials.gov：NCT03236025。
