Thursday, July 10, 2003

This presentation is part of : Outcomes Measurement

Smoking Hygiene: Reducing Infant Exposure to Tobacco

Mary Beth Flanders Stepans, RN, PhD, Associate Professor1, Susan Wilhelm, RN, PhD, Postdoctoral Student1, Kurt Dolence, PhD, Assistant Professor2, and Keri R. Pulley, RN, FNP-C3. (1) School of Nursing, University of Wyoming, Laramie, WY, USA, (2) School of Pharmacy, University of Wyoming, Laramie, WY, USA, (3) Sun Valley Medical Group, Cheyenne, WY, USA
Learning Objective #1: Describe the three components of a smoking hygiene intervention
Learning Objective #2: Describe two measures of infant exposure to tobacco

Objective: The purpose of this pilot study was to determine the effect of the nursing intervention, smoking hygiene, on infants of smoking breastfeeding mothers.

Design: A quasi-experimental design with repeated measures was used.

Population, Sample, Setting: A convenience sample of 34 mother-infant pairs was recruited from 6 sites.

Intervention and Outcome Variables: Smoking hygiene is defined as actions taken by the mother to protect her infant from the components of cigarette smoke. Smoking hygiene included the following: a) the infant was not in the same room or car with someone who was smoking; b) the mother smoked only immediately after breastfeeding and at least 90 minutes before the next feeding; and c) a room air cleaner was placed in the infant’s room. Outcome variables were infant urinary nicotine and cotinine levels, maternal breastmilk nicotine and cotinine levels as well as frequency of infant respiratory symptoms of illness.

Methods: Mother-infant pairs were randomly assigned to either intervention or control groups. Although 4 women dropped out of each group, data were analyzed on 26 mother-infant pairs (intervention n=15; control n=11). Smoking hygiene was introduced to members of the intervention group when the infant was two weeks of age and reintroduced at three and five weeks of age.

Findings: Repeated measures ANOVA revealed no difference in a) infant urinary nicotine (f=2.94(2,24); p=.072) and cotinine levels (f=.27(2,23); p=.77) ; b) breast-milk nicotine (f=1.90(2,23); p=.17) and cotinine levels (f=.86(2,23); p=.43) when comparing samples from the two groups. McNemar test for related samples revealed no difference between frequency of respiratory symptoms in either control or intervention groups when week 2 was compared to week 3 and 5.

Conclusions: There was no difference in levels of infant exposure to tobacco.

Implications: To adequately test the intervention, smoking hygiene, measures that are sensitive to intervention must be identified.

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Sigma Theta Tau International
10-12 July 2003