Severson H H, Andrews J A, Lichtenstein E, Wall M, Akers L
Oregon Research Institute, Eugene 97403, USA.
Prev Med. 1997 Jan-Feb;26(1):120-30. doi: 10.1006/pmed.1996.9983.
Pediatric well-care visits provide a clinical opportunity to counsel new mothers about their smoking and the deleterious effects of environmental tobacco smoke (ETS) on infant health.
Forty-nine Oregon pediatric offices enrolled 2,901 women who were currently smoking or had quit for pregnancy, using a brief survey at the newborn's first office visit. Randomly assigned offices provided advice and materials to mothers at each well-care visit during the first 6 months postpartum to promote quitting or relapse prevention.
The intervention reduced smoking (5.9% vs 2.7%) and relapse (55% vs 45%) at 6-month follow-up, but logistic regression analysis at 12 months revealed no significant treatment effect. The intervention had a positive effect on secondary outcome variables, such as readiness to quit and attitude toward and knowledge of ETS. Multiple logistic regression analysis indicated that husband/partner smoking was the strongest predictor of maternal quitting or relapse.
A pediatric office-based intervention can significantly affect smoking and relapse prevention for mothers of newborns, but the effect decreases with time. Consistent prompting of the provider to give brief advice and materials at well-care visits could provide a low-cost intervention to reduce infant ETS exposure.
儿童健康检查为向新妈妈提供有关吸烟及环境烟草烟雾（ETS）对婴儿健康的有害影响的咨询提供了临床契机。
俄勒冈州的49家儿科诊所通过在新生儿首次就诊时进行简短调查，招募了2901名目前正在吸烟或为怀孕而戒烟的女性。随机分配的诊所会在产后前6个月的每次儿童健康检查时为母亲提供建议和材料，以促进戒烟或预防复吸。
在6个月随访时，干预措施减少了吸烟率（5.9%对2.7%）和复吸率（55%对45%），但12个月时的逻辑回归分析显示无显著治疗效果。该干预措施对次要结局变量有积极影响，如戒烟意愿以及对ETS的态度和认识。多项逻辑回归分析表明，丈夫/伴侣吸烟是母亲戒烟或复吸的最强预测因素。
基于儿科诊所的干预措施可显著影响新生儿母亲的吸烟及复吸预防情况，但效果会随时间减弱。医护人员在儿童健康检查时持续进行简短建议并提供材料，可为减少婴儿ETS暴露提供低成本干预措施。
