Helping smoking fathers with an infant to quit: The family-based intervention impact on marital satisfaction and partner support to quit

Abstract

BACKGROUND AND OBJECTIVES: Nurse-led family-based smoking cessation intervention supported mothers to help smoking fathers quit. We examined if a family-based smoking cessation intervention (1) improved marital relationship; (2) increased non-smoking partner’s support. We also tested if change on marital satisfaction and partner support influenced the smoking fathers’ abstinence. METHODS: 1,158 smoking fathers with non-smoking wives and infants who participated in a randomized controlled trial was randomized to (1) a nurse-led family-based smoking cessation intervention including individual and family counseling, or (2) a self-help education pamphlet about smoking cessation and establishing a smokefree home. The ENRICH marital satisfaction and the Partner Interaction Questionnaire (PIQ) were used to assess marital satisfaction and mothers’ behavior to help fathers, respectively, at baseline and 12-month follow-up. Generalized linear model was used to test if the changes in these scales were different between the RCT groups. Multivariate logistic regression was used to examine the association between these scales and fathers’ abstinence. FINDINGS: At 12-month follow-up, there was a greater reduction in mothers’ negative behaviors including criticism, suspicious on his ability to quit and negative expressions on smoking in the intervention group than control (F=4.02, p=0.04). Marital satisfaction significantly increased in both RCT groups, but no difference between them was found (F=0.52, p=0.47). After adjusting for treatment group and baseline smoking characteristics, increase in mothers’ marital satisfaction (Adjusted odds ratio (AOR) = 1.03, 95% CI 1.01-1.05) and decrease in negative behaviors in supporting fathers’ quitting (AOR = 0.96, 95% CI 0.93-0.98) were associated with more fathers’ self-reported abstinence. CONCLUSIONS: The family-based intervention did not affect marital satisfaction, and it was effective in reducing mothers’ negative behaviors in supporting fathers’ quitting and hence increased fathers’ abstinence. Funding: Health and Health Services Research Fund, Food and Health Bureau, Hong Kong SAR Government (HHSRF #05060751) and Flight Attendant Medical Research Institute, USA (FAMRI reference no.: 062496) Corresponding Author: Yee Tak Derek Cheung, The University of Hong Kong, Hong Kong, derekcheung@hku.hk