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. 2017 Aug 1;19(8):930-936.
doi: 10.1093/ntr/ntw330.

Developing a Biomarker Feedback Intervention to Motivate Smoking Cessation During Pregnancy: Phase II MAW Study

Kathryn R Koller  1 , Christie A Flanagan  1 , Gretchen E Day  1 , Timothy K Thomas  1 , Christina A Smith  2 , Abbie W Wolfe  1 , Crystal Meade  1 , Christine A Hughes  2 , Vanessa Y Hiratsuka  3 , Neil J Murphy  3 , Christi A Patten  2
Affiliations

Developing a Biomarker Feedback Intervention to Motivate Smoking Cessation During Pregnancy: Phase II MAW Study

Kathryn R Koller et al. Nicotine Tob Res. .

Abstract

Introduction: The prevalence of smoking during pregnancy for Alaska Native (AN) women is more than triple that of non-Native Alaska women. In this qualitative study, we solicited input from AN women and others to determine how best to present findings from an earlier study demonstrating a strong correlation between biomarkers for maternal smoking (cotinine) and neonatal exposure to a tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) to motivate cessation.

Methods: We developed a brochure incorporating generalized biomarker information. Using in-depth individual interviews with pregnant and postpartum AN women and partners/family members, we explored applicability and acceptability of the information. Postpartum women, who had participated in the earlier correlation study, additionally received their individual biomarker results. We assessed whether being presented general or individual biomarker information would motivate cessation using content analysis.

Results: We conducted 39 interviews: 16 pregnant women, 12 postpartum women, and 11 partners/family members. Overall, participants agreed the biomarker information was new, but understandable as presented. Postpartum women shared that learning their personal results inspired them to want to quit or cut back smoking while pregnant women indicated the generalized correlation information was less helpful in motivating cessation.

Conclusion: Generalized information about fetal exposure to carcinogens may be more effective in motivating pregnant women to quit smoking when combined with individual cotinine testing.

Implications: Using feedback from this study, we refined and are currently evaluating an intervention incorporating generalized correlation information from Phase I and cotinine testing to determine its effectiveness in motivating smoking cessation among pregnant AN women.

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Figures

Figure 1.
Figure 1.
Brochure talking points: Cotinine and NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol) are breakdown products of tobacco and can be measured in urine. Cotinine in a pregnant mother’s urine reflects the amount of tobacco she has used. NNAL has been shown to cause cancer. The more tobacco a pregnant woman uses, the more NNAL she and her unborn baby are exposed to. NNAL and cotinine not true to scale. NNAL measured in pg/mL; cotinine measured in ng/mg-creat.
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References

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