Author (year) | Study Design and Setting | Participants | Intervention | Outcomes | Findings |
---|---|---|---|---|---|
El-Mohandes (2010) [22] | RCT USA | African American women at 6 prenatal care sites I = 335; C = 356 | Integrated Behavioural Intervention using role play and skills practice to build negotiation skills with partner and other smoking family members and to enhance knowledge of SHS harm. | Self-reported environmental tobacco smoke exposure (ETSE), birth weight and gestational age at delivery Sub group with <20 ng/ml saliva cotinine used to represent median number with no. cigarettes smoked | Logistic regression analysis: ETSE OR 0.5 (0.35,0.71); <20 ng/ml: 0.57(0.38,0.84). LBW: I = 9.5%, C = 13.5%, p = 0.11; VLBW: I = 0.4%, C = 3.1%, p = 0.02; Pre-term birth: I = 11.6%, C = 13.5%, p = 0.49; Very pre-term: I = 1.4%, C = 5.6%, p = 0.01 |
Karatay (2010) [26] | Before-after study Turkey | Educated smoking pregnant women selected from ANC. N = 45; 38 completed | Motivational interviews based on TTM. Eight weekly visits at home with data on baseline smoking habits, raising awareness, motivation to quilt, asking all smokers not to smoke at home and evaluation of self-efficacy score. | Self-reported smoking and reduction in SHS exposure | Reduction in SHS 86.8% at first visit to 47.7% at final visit (p < 0.05) Measured CO and urine cotinine to verify quitting smoking but did not report if SHS reduction had any impact on these levels |
Huang (2013) [24] | RCT Taiwan | Pregnant women from Urban Taiwan I = 65; C = 70 | Intervention based on TTM. DVD informing about effects of SHS and strategies to avoid SHS; a booklet about the stages of change, quizzes, and exercises to reinforce the information; accessory tools such as stickers, bibs, door hangers with no smoking signs. | Stages of change i) pre-contemplation ii) contemplation/preparation iii) action/maintenance Determinants of Change i) Knowledge ii) Experiential process iii) Behavioural process Decisional Balance i) Pros ii) Cons Self-efficacy | I vs C Stages of change i) 3 (4.6%) vs 8 (11.4%) ii) 4 (6.2%) vs 12 (17.1%) iii) 58 (89.2%) vs 50(71.4%) Determinants of Change i) 15.04 SD 0.18 vs 12.46 SD 0.24 ii) 44.32 SD 0.43 vs 40.39 SD 0.51* (p = 0.025) iii) 38.86 SD 0.74 vs 31.83 SD 0.78 Decisional Balance i)19.27 SD 0.18 vs 18.27 SD 0.21 ii) 12.02 SD 0.51 vs 13.23 SD 0.46 Self-efficacy 16.28 SD 0.8 vs 13.29 SD 0.43 *denotes statistically significant |
Kazemi (2012) [23] | RCT Iran | Pregnant women recruited from 10 health centres. 91/130 completed study; I = 47; C = 44 | 5 sessions with 4-week interval of education package informed by HBM. This comprised a pictorial booklet and face to face verbal session. | Perceived susceptibility Perceived severity Perceived benefits of avoiding SHS Perceived barriers to avoiding SHS Weekly ETSE exposure defined as mean number of cigarettes smoked close to pregnant woman each week by husband | Scores at final visit Perceived susceptibility I 17.93 SD2.23; C 16.29 SD 3.27 Perceived severity I 17.85 SD2.24; C 16.83 SD 2.76 Perceived benefits I 22.8 SD2.1; C 21.14 SD 2.94 Perceived barriers I 6.57 SD1.75; C 6.93 SD 1.47 Weekly ETSE: I 12.28 SD 15.1 C 25.39 SD 13.2 F-stat 8.68, p < 0.0001 for diff b/w groups on t-test; mean ETSE exposure difference at baseline and last week in I and C: −19.49 |
Loke and Lam (2005) [25] | RCT China | 758 Literate pregnant women attending ANC | Intervention informed by the Theory of Reasoned Action. Standardised advice from obstetrician and an education booklet which described simple strategies helping husbands to quit smoking. | Attempt to quit in past 7 days Change in number of cigarettes per day in last month Quit smoking completely in last 7 days; quit for last 30 days or more Attempted and actual quitting. Post-intervention questionnaire was administered around 36 weeks of pregnancy. | Number of quit attempts None: I 266 (70%) vs C 294 (78%) ≥1: I 114 (30%) vs C 84 (22%); p = 0.02. Changes in number of cigarettes smoked I : 151 (39.7%) vs C 67 (17.7%) No change I 193 (50.8%) vs C 267 (70.7%) Increase I 36 (9.5) vs C 44 (11.6%) (p < 0.0001) Quit smoking in last 7 days I 32 (8.4%) vs C 18 (4.8%) (p = 0.04) Quit smoking for last 30 days or more: I 23(6.1%) vs C 16 (4.2%) (p = 0.26) |
Lee (2008) [17] | Before-after study China | Non-smoking pregnant women with husband smokers recruited from antenatal clinics of 3 hospitals for 6 focus groups; N = 55 128 women recruited to pilot study. | Intervention informed by HBM with reference to Social Cognitive Theory. Advice from the doctor (noted in the clinical records for clinicians to reinforce the message), hot telephone line for counselling and advice delivered bi-weekly over the telephone by the researcher. Round up meeting with all to share their experiences and a resource booklet. | Knowledge about harmful components of SHS Disease due to SHS Harm to pregnancy Dislike SHS Assertive action against husband's smoking Assertive action against family member smoking | Change from before to after Knowledge of harmful components 32% to 92% (p < 0.01) Knowledge of disease 19.5% to 74.2% (p < 0.01) Knowledge of harm 38% to 73% (p < 0.01) Dislike SHS 51% to 83% (p < 0.01) Assertive action against husband 92% to 98% (p < 0.05) Assertive action against family member 56% to 87% (p < 0.01) |