Home visiting and perinatal smoking: a mixed-methods exploration of cessation and harm reduction strategies.

TitleHome visiting and perinatal smoking: a mixed-methods exploration of cessation and harm reduction strategies.
Publication TypeJournal Article
Year of Publication2016
AuthorsGriffis H, Matone M, Kellom K, Concors E, Quarshie W, French B, Rubin D, Cronholm PF
JournalBMC Public Health
Volume16
Issue1
Pagination764
Date Published2016 08 11
ISSN1471-2458
KeywordsAdult, Female, House Calls, Humans, New England, Pregnancy, Prenatal Care, Prenatal Exposure Delayed Effects, Propensity Score, Retrospective Studies, Smoking, Smoking Cessation, Tobacco Products
Abstract

BACKGROUND: Home visiting programs represent an important primary prevention strategy for adverse prenatal health behaviors; the various ways in which home visiting programs impact prenatal smoking cessation and reduction behaviors remain understudied.

METHODS: Mixed methods approach using a retrospective cohort of propensity score matched home visiting clients and local-area comparison women with first births between 2008-2014 in a large Northeast state. Multivariable logistic and linear regression estimated third trimester prenatal tobacco smoking cessation and reduction. Additionally, qualitative interviews were conducted with 76 home visiting clients.

RESULTS: A program effect was seen for smoking cessation such that clients who smoked less than ten cigarettes per day and those who smoked 20 or more cigarettes per day during the first trimester were more likely to achieve third trimester cessation than comparison women (p <0.01 and pā€‰=ā€‰0.01, respectively). Only for heavy smokers (20 or more cigarettes during the first trimester) was there a significant reduction in number of cigarettes smoked by the third trimester versus comparison women (pā€‰=ā€‰0.01). Clients expressed the difficulty of cessation, but addressed several harm-reduction strategies including reducing smoking in the house and wearing a smoking jacket. Clients also described smoking education that empowered them to ask others to not smoke or adopt other harm reducing behaviors when around their children.

CONCLUSIONS: While a significant impact on smoking cessation was seen, this study finds a less-clear impact on smoking reduction among women in home visiting programs. As home visiting programs continue to expand, it will be important to best identify effective ways to support tobacco-related harm reduction within vulnerable families.

DOI10.1186/s12889-016-3464-4
Alternate JournalBMC Public Health
PubMed ID27514836
PubMed Central IDPMC4982407