Randomised controlled trial of home based motivational interviewing by midwives to help pregnant smokers quit or cut downBMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7513.373 (Published 11 August 2005) Cite this as: BMJ 2005;331:373
- D M Tappin, director ()1,
- M A Lumsden, professor2,
- W H Gilmour, senior lecturer in medical statistics3,
- F Crawford, public health project manager4,
- D McIntyre, director5,
- D H Stone, professor1,
- R Webber, chief medical laboratory scientific officer6,
- S MacIndoe, administrator1,
- E Mohammed, lead research midwife1
- 1 Paediatric Epidemiology and Community Health Unit, Department of Child Health, Division of Developmental Medicine, University of Glasgow, Yorkhill, Glasgow G3 8SJ
- 2 Section of Obstetrics and Gynaecology, Division of Developmental Medicine, University of Glasgow, Glasgow G31 2ER
- 3 Section for Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow, Glasgow G12 8RZ
- 4 NHS Health Scotland, Clifton House, Glasgow G3 7LS
- 5 International Non Governmental Coalition Against Tobacco, PO Box 42134, London SW8 4WS
- 6 Haematology Department, Yorkhill Hospital, Glasgow G3 8SJ
- Correspondence to: D M Tappin
- Accepted 26 May 2005
Objective To determine whether motivational interviewing—a behavioural therapy for addictions—provided at home by specially trained midwives helps pregnant smokers to quit.
Design Randomised controlled non-blinded trial analysed by intention to treat.
Setting Clinics attached to two maternity hospitals in Glasgow.
Participants 762/1684 pregnant women who were regular smokers at antenatal booking: 351 in intervention group and 411 in control group.
Interventions All women received standard health promotion information. Women in the intervention group were offered motivational interviewing at home. All interviews were recorded.
Main outcome measures Self reported smoking cessation verified by plasma or salivary cotinine concentration.
Results 17/351 (4.8%) women in the intervention group stopped smoking (according to self report and serum cotinine concentration < 13.7 ng/ml) compared with 19/411(4.6%) in the control group. Fifteen (4.2%) women in the intervention group cut down (self report and cotinine concentration less than half that at booking) compared with 26 (6.3%) in the control group. Fewer women in the intervention group reported smoking more (18 (5.1%) v 44 (10.7%); relative risk 0.48, 95% confidence interval 0.28 to 0.81). Birth weight did not differ significantly (mean 3078 g v 3048 g).
Conclusion Good quality motivational interviewing did not significantly increase smoking cessation among pregnant women.
A copy of the patients' information sheet and details of the two interviews can be found on bmj.com
Contributors DMT was involved in conception, design, and implementation of study, analysis and interpretation of data, and drafting, revising, and final approval of the article. MAL and WHG were involved in conception, design, and implementation of study, interpretation of data (final report writing), and drafting, revising, and final approval of the article. MAL was also responsible for the study intervention process. K Cooper produced the envelopes for random allocation with supervision from WHG. RW was involved in conception and implementation of study. FC was involved in conception, design, and implementation of study, and interpretation of data. DHS was involved in conception, design, and implementation of study, and drafting, revising, and final approval of the article. DM was involved in conception and design. S MacIndoe was involved in implementation of study and provided random allocation by telephone. E Mohammed was involved in implementation of study. P Meldrum gave advice on information needed for financial analysis. J Allison trained the midwives in motivational interviewing and mentored the midwives on one day a month throughout the study period. T Thornton and E Mitchell collected late pregnancy information. D Barnett, S McGuigan, and L Jarvie (research midwives) provided home based motivational intervention. L Govan assisted with the statistical analysis. Ian White, MRC Biostatistics Unit Cambridge, provided guidance on compliance analysis. DMT is guarantor.
Funding Chief Scientist at the Scottish Executive, the Scottish Cot Death Trust, and the BUPA Foundation.
Competing interests None declared.
Ethical approval Ethics committees for the Queen Mother's and the Princess Royal Maternity hospitals approved the study.
- Accepted 26 May 2005