Motivational counselling, financial incentives help promote smoke-free homes for infants

A hospital-initiated maternal intervention, consisting of motivational interviewing and financial incentives, successfully reduces their infants’ exposure to tobacco smoke, a recent study has shown.

Researchers randomly assigned 360 mothers with babies in the neonatal intensive care to receive either the test intervention of motivational interviewing and financial incentives, which were given according to session attendance and upon a negative infant serum cotinine test (n=182; mean age, 27.0±5.9 years), or conventional care (n=178; mean age, 26.5±5.9 years).

At baseline, around 20 percent of the participants were smokers and 78.7 percent noted that their partners were smokers. Around half of the mothers reported imposing a smoking ban at their homes or cars.

Researchers found no cross-sectional effect of the interview-and-financial-incentive intervention at the midpoint of treatment (p≤0.98), nor at the follow-ups at 1 month (p≤0.73) and 4 months (p≤0.25). A similar null effect was found on longitudinal changes in infant urine cotinine values (p≤0.12).

However, when restricting the analysis to the subgroup of mothers who had completed the protocol as intended, the intervention appeared to bear a significant beneficial effect on longitudinal cotinine changes in infants (p≤0.02). In absolute terms, infants of mothers assigned to conventional care saw a 0.31-percent increase in serum cotinine per day, as opposed to no discernible change in their intervention comparators.

Moreover, the intervention was significantly effective in mothers who showed baseline readiness to protect their infants from tobacco smoke (p≤0.006) but was ineffective in those who had no such motivations (p≤0.11).

“Resources invested during infant hospitalization to reduce child and family tobacco smoke exposure have the potential to reduce health risks in medically fragile children as well as mothers and fathers in their child-bearing years, potentially saving years of quality life and millions in healthcare dollars,” researchers said.