Elsevier

Preventive Medicine

Volume 38, Issue 1, January 2004, Pages 6-9
Preventive Medicine

Randomised control trial of a smoking cessation intervention directed at men whose partners are pregnant

https://doi.org/10.1016/j.ypmed.2003.09.021Get rights and content

Abstract

Background. Although smoking cessation programs significantly reduce smoking rates in the general population, some sectors are poorly motivated by them, especially healthy men from lower socioeconomic classes.

Methods. By using a significant life event (approaching birth of a child) we exploited a time of increased receptiveness to smoking cessation influences. A multicomponent intervention was conducted and evaluated using a stratified, randomised control trial, with an intention to treat analysis.

Results. Five hundred and sixty-one men were enrolled and 505 (90%) followed to the end of their partners' pregnancy. At 6-month follow-up 16.5% of 291 smokers of the intervention group and 9.3% of 270 in the control group reported they had stopped smoking (P = 0.011, OR = 0.52, 95% CI 0.31 – 0.86). The strongest predictors of smoking cessation were being in a skilled occupation, having a higher number of quit attempts in the previous year and having the first cigarette of the day relatively later.

Conclusions. The number of smoking men who had to be treated to achieve one stopping smoking (NNT) during their partner's pregnancy was 13 to 14. Innovative antismoking population health measures for the partners of antenatal patients are effective and perhaps should be more widely adopted.

Introduction

Traditionally antismoking interventions aimed at the most preventable cause of cancer [1] target high-risk groups such as pregnant women [2] or cardiovascular patients [3]. Healthy men from socioeconomically deprived classes, who historically have a higher prevalence of smoking [4], [5], have hitherto escaped this preventive focus.

One rationale of cessation programs for pregnant women has been based on the principle that pregnancy is a significant life event and mothers are concerned about the effects of smoking on their babies and themselves. The smoking status of a pregnant smoker's partner influences her chances of stopping smoking [6], [7], so the focus of smoking cessation programs has broadened from primarily on the expectant mother to include the pregnant smoker's partner [8]. Fathers are more likely to stop smoking in the 2 years preceding childbirth and be abstinent 1 year after the birth of their child [9]. The birth of their child may represent the best opportunity for success of any intervention designed to increase cessation rates of men in unskilled occupations, who are more likely to be smokers [10] and relatively less likely to succeed in stopping [11], [12].

Section snippets

Methods

Over a period of 35 months we identified men who smoked when their partners booked into the public antenatal clinic at two large Brisbane metropolitan hospitals. Of the eligible sample of 808 men nominated by their partners 67 (8.3%) were found not to meet the eligibility criteria for the study when the males were contacted. Among the remaining 741, 180 (24.3%) refused to participate in the study, giving 561 men recruited into the study at the baseline interview and a response rate of 75.7%. At

Results

Among the participants recruited following their partner booking into an antenatal clinic who completed the follow-up interview at end of pregnancy, 73 reported quitting. A sample of 45 participants was asked to provide a carbon monoxide reading for verification of smoking status (intervention n = 24, control n = 21). Among this group 95.8% of the intervention group and 66.7% of the control group were verified as quitters (seven who refused were classified as smokers). Therefore self-reported

Discussion

We have shown that a minimal intervention consisting of providing a video and print information for blue collar males, together with limited access to nicotine replacement and reminder systems, can increase the quit rate compared to simply providing information about resources. This is a better finding than where the multicomponent smoking cessation program for lower socioeconomic African Americans found no improvement at 6-month follow-up [14]. Perhaps our focus on free patches was important:

Acknowledgements

The study was conducted and analysed by the Cancer Prevention Research Centre through a grant from Queensland Health, commissioned Cancer Research Grant funds. Thanks to the generous support of the study GPs, Dr John Price and Dr Laurel Moore, who contacted smokers.

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