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Nicotine & Tobacco Research Advance Access published online on June 24, 2009
Nicotine & Tobacco Research, doi:10.1093/ntr/ntp095
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© The Author 2009. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Ultrasound feedback and motivational interviewing targeting smoking cessation in the second and third trimesters of pregnancy

Angela L. Stotts, Janet Y. Groff, Mary M. Velasquez, Ruby Benjamin-Garner, Charles Green, Joseph P. Carbonari and Carlo C. DiClemente

Angela L. Stotts, Ph.D., Department of Family and Community Medicine, University of Texas Medical School at Houston, Houston, TX
Janet Y. Groff, M.D., Ph.D., Department of Family and Community Medicine, University of Texas–Houston Medical School, Houston, TX
Mary M. Velasquez, Ph.D., School of Social Work, University of Texas–Austin, Austin, TX
Ruby Benjamin-Garner, Ph.D., University of Texas–Houston Medical School, Houston, TX
Charles Green, Ph.D., Department of Pediatrics, University of Texas–Houston Medical School, Houston, TX
Joseph P. Carbonari, Ed.D., Department of Psychology, University of Houston, Houston, TX
Carlo C. DiClemente, Ph.D., Department of Psychology, University of Maryland–Baltimore County, Baltimore, MD

Corresponding Author:Angela L. Stotts, Ph.D., Department of Family and Community Medicine, University of Texas Medical School at Houston, 6431 Fannin, JJL 324, Houston, TX 77030, USA. Telephone: 713-500-7590; Fax: 713-500-7606; E-mail: angela.l.stotts{at}uth.tmc.edu


  Abstract

Introduction: Cigarette smoking during pregnancy is associated with poor maternal and child health outcomes. Effective interventions to increase smoking cessation rates are needed particularly for pregnant women unable to quit in their first trimester. Real-time ultrasound feedback focused on potential effects of smoking on the fetus may be an effective treatment adjunct, improving smoking outcomes.

Methods: A prospective randomized trial was conducted to evaluate the efficacy of a smoking cessation intervention consisting of personalized feedback during ultrasound plus motivational interviewing-based counseling sessions. Pregnant smokers (N = 360) between 16 and 26 weeks of gestation were randomly assigned to one of three groups: Best Practice (BP) only, Best Practice plus ultrasound feedback (BP+US), or Motivational Interviewing-based counseling plus ultrasound feedback (MI+US). Assessments were conducted at baseline and end of pregnancy (EOP).

Results: Analyses of cotinine-verified self-reported smoking status at EOP indicated that 10.8% of the BP group was not smoking at EOP; 14.2% in the BP+US condition and 18.3% who received MI+US were abstinent, but differences were not statistically significant. Intervention effects were found conditional upon level of baseline smoking, however. Nearly 34% of light smokers (≤10 cigarettes/day) in the MI+US condition were abstinent at EOP, followed by 25.8% and 15.6% in the BP+US and BP conditions, respectively. Heavy smokers (>10 cigarettes/day) were notably unaffected by the intervention.

Discussion: Future research should confirm benefit of motivational interviewing plus ultrasound feedback for pregnant light smokers and explore mechanisms of action. Innovative interventions for pregnant women smoking at high levels are sorely needed.

Received: September 24, 2008; Accepted: March 5, 2009
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