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A Smoking Cessation Program in the Neonatal Intensive Care Unit

Published online by Cambridge University Press:  21 February 2012

Stephen K. Ling
Affiliation:
The John Hunter Hospital Drug and Alcohol Service, Newcastle, Australia.
Susanne Wooderson
Affiliation:
Neonatal Intensive Care Unit, The John Hunter Children's Hospital, Newcastle, Australia.
Karen Rees
Affiliation:
Neonatal Intensive Care Unit, The John Hunter Children's Hospital, Newcastle, Australia.
Rose Neild
Affiliation:
The John Hunter Hospital Drug and Alcohol Service, Newcastle, Australia.
Ian M.R. Wright*
Affiliation:
Neonatal Intensive Care Unit, The John Hunter Children's Hospital, Newcastle, Australia; Mother and Babies Research Centre, Hunter Medical Research Institute, University of Newcastle, Australia. Ian.Wright@hnehealth.nsw.gov.au
*
*Address for correspondence: Ian M.R. Wright FRACP, Senior Staff Specialist in Neonatal Medicine, John Hunter Children's Hospital, Lookout Rd, New Lambton Hts NSW 2310, Australia.

Abstract

Background: Parental smoking remains a significant risk to the preterm infant both pre and post delivery. Pharmacologically supported interventions have been previously contraindicated in this group during the perinatal period and during breastfeeding. We designed an evidence-based intervention for use in our high-risk population. This report assesses our outcomes after one year. Method: Questionnaire administered a median of 6 months after intervention. Results: There was no significant difference between those participants who returned the survey (n = 42) versus the group as a whole (n = 70). A total of 33% ceased smoking, p < .0001. If no nonresponders ceased smoking then this gives an overall success rate of 20%, p < .0001. Successful quitters had been smoking for a mean of 11 (SD = 7) years. Self-reported light smokers (< 10 cigarettes per day) were significantly more likely to quit (p < .01). Purchase of follow-on nicotine patches was a significant predictor of success in quitting (p = .02). If relapse occurred, it appeared to happen early and was mainly associated with current stressors. Conclusions: We have designed and applied a multidisciplinary intervention for parents and carers to be used in the perinatal period to decrease the postnatal risk for neonatal intensive care graduates. Our rates of successful smoking cessation are as good as, or better than, many published rates for opportunistic intervention. We suggest that randomised trials be focused on ways to further improve interventions at this time of opportunity for these infants and their families.

Type
Articles
Copyright
Copyright © Cambridge University Press 2008

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