The Quit Together couples-focused pilot randomized trial of tobacco cessation for pregnant smokers

Abstract

Aims

This study reports on the feasibility and preliminary efficacy of prenatal and postnatal couples-focused telephone counseling for pregnant tobacco smokers.

Design and setting

This pilot randomized controlled trial (RCT) was conducted online in Romania and enrolled a total of 90 pregnant smokers and 77 of their life partners.

Participants

90 adult pregnant smokers and 77 of their life partners were randomized either to (1) Motivation and Problem Solving (MAPS) telephone counseling (n = 45 pregnant smokers who received up to 8 pre/postnatal telephone counseling sessions and n = 40 partners who received up to 4 sessions) or (2) usual care (n = 45 pregnant smokers and n = 37 partners).

Measurements

The primary outcomes were maternal 7-day self-reported and biochemically verified tobacco point-prevalence abstinence (PPA) and prolonged abstinence (PA) between birth and three months postpartum. Unadjusted group comparisons were used to assess preliminary intervention efficacy.

Findings

20 % of women in the intervention group reported PPA, compared to 15.6 % (p = 0.58) in the usual care group. Women (n = 15) who received three or more counseling sessions had higher PPA (40.0 vs 15.6 %, p < 0.05) than women in the usual care group. 8.9 % of the women in the intervention group had biochemically verified abstinence compared to 4.4 % (p = 0.67) in the usual care group, with a significantly higher rate among women who received at least three counseling sessions (26.7 % vs 4.4 %, p = 0.03).

Conclusion

A prenatal and postnatal couple-focused telephone counseling intervention for pregnant smokers is feasible and provides preliminary efficacy of cessation and postpartum abstinence when a minimum intervention dosage is delivered.