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Table 4 Methods and results of included studies

From: A systematic review and narrative summary of family-based smoking cessation interventions to help adults quit smoking

Author

Country

Main target group for smoking cessation

Family member involved in intervention

Smoking behaviour of main target group and family member

Sample*

Reason for involving family

Smoking outcome measure/length follow up

Comparison groups (interventions described fully in Table 5)

Results: Are family-based interventions more effective?

Hjermann et al. [38]

Norway

Men at risk of coronary heart disease and aged 20-49 years with no evidence of diseases of the cardiovascular system, diabetes psychopathological disease or alcoholism

Wives

Smoking behaviour of the main target group (men at risk of coronary heart disease) and family members was not an eligibility criteria

1232 healthy, normotensive men at high risk of coronary heart disease; 604 intervention and 628 control group respectively. Number of family members not given

None given

Self-reported smoking habits; 5 years

Lifestyle intervention involving wives vs. control group (not described)

It is unclear if the ‘active ingredient’ of the wives’ involvement influenced effectiveness because this was not tested

The intervention was effective for men. Tobacco consumption (expressed as number of cigarettes per man per day; pipe smoking is included taking one pack of pipe tobacco weekly to equal 7 cigarettes daily) fell about 45 % more in the intervention group than in the controls

McBride et al. [34]

North America

Pregnant women (current or recent quitters) living intimately with their partners

Partners

The main target group was a current smoker or recent quitter; smoking behaviour of partner was not included in eligibility criteria

583 pregnant women and 583 partners. 198 pregnant women in usual care group, 192 pregnant women in women only group and 193 pregnant women in the partner assisted group

Marital theory and empirical research show how marital relationships might affect provision of support for smoking cessation

Self-reported smoking status baseline (about 11 weeks of pregnancy), at 28 weeks of pregnancy, and at 2-, 6-, and 12-months postpartum. Saliva samples were collected by mail at 28 weeks of pregnancy and at 12 months postpartum from women and partners who reported not smoking

3 groups: Women in the usual care group received advice to quit and a self-help guide vs. women in the women only group also receiving a late-pregnancy relapse prevention kit (booklet and gift items) and six counseling calls vs. women in the partner-assisted group also having their partners receiving telephone counseling and a support guide emphasizing skills to help the woman build and maintain her confidence to quit smoking

No for pregnant women. Intent-to-treat analyses showed no significant differences by group in women’s reports of abstinence at any follow-up

Yes for partners. In late pregnancy, more partners were abstinent in the partner assisted group (15 %) than in the usual care group (5 %), p = 0.02

McIntyre-Kingsolver et al. [39]

North America

Adult smoker in a committed live-in relationship with a spouse or spouse-equivalent

Spouse or partners

The main target group was a smoker; smoking behaviour of partner was not included in eligibility criteria

64 couples. Subjects were required to be in a committed, live-in relationship with a spouse or spouse-equivalent who was willing to attend the treatment sessions

Perceived helpfulness from a spouse and verbal encouragement and cooperative participation may be an asset to cessation and maintenance

Self-report smoking status and abstinence and reports of significant others; saliva thiocyanate (SCN) and/or level of alveolar carbon monoxide (CO); 1 and 6 months follow up

Spouse training vs. usual treatment to aid a smoking cessation

No. There was a consistent trend in favour of the partner training treatment, but even the largest difference (72.7 % vs. 48.4 % abstinent), at the end of treatment, was not significant.

Nyborg and Nevid [41]

North America

Couples who both smoke and live together and both seeking to quit or reduce smoking and both smoking > 20 cigarettes a day

Spouse or partner who also smoked

To be eligible both individuals that comprised the couple had to smoke

40 couples living together randomly assigned to 1 of 5 treatment groups

Social support

Self-reported abstinence post-treatment and 3 and 6 months

5 different types of smoking cessation interventions compared: 2 couple-based and 2 individual-based therapy groups and a group just given written materials

No. Abstinence rates for couples were not significantly different across groups at follow-up intervals,

Øien et al. [36]

Norway

Pregnant women

Spouse or partners

The smoking behaviour of the main target group (pregnant women) and the family member (partner) was not included in the eligibility criteria

Pregnant women and partners: intervention cohort (N = 2051) and the control cohort (N = 1788). Number of partners not given

None given

Self-reported smoking behaviour; 9-12 weeks gestation, and at 6 weeks after delivery

A cohort given smoking cessation intervention vs. a cohort not given the intervention

It is unclear if the ‘active ingredient’ of partner spouses’/partners’ involvement influenced effectiveness because this was not tested

The intervention was not effective for pregnant women. Data stratified according to smoking behaviour at the beginning of pregnancy demonstrated that in the intervention cohort only one in four of the smoking women continued to smoke from the beginning of pregnancy until inclusion, with no significant difference between the cohorts.

Yes for partners. In contrast, most men continued to smoke in the same period, but significantly fewer in the intervention cohort

Patten et al. [40]

North America

Parent (biological, adopted, step parent or adult guardian) who currently smoked ≥5 cigarettes per day

Child aged 13-19 years, never smoked or if a former smoker had not smoked during past 6 months, and interested in helping parent quit

The main target group (parent) was a current smoker and the family member (child) either never smoked or had quit

40 non-smoking adolescents (13–19 years) interested in helping a parent (biological, adopted, step parent or adult guardian) to quit who currently a) smoked >=5 cigarettes per day

Adolescents are concerned about parents who smoke and wish to help them quit

At each follow-up point prevalence of abstinence defined as no cigarettes smoked (not even a puff) for previous 7 days. Confirmed at 6 months by salivary cotinine concentration of <15 ng/ml. Quit attempts since time of enrolment assessed at each follow-up; 6 and 12 weeks and 6 months

2 smoking cessation interventions compared: Health education vs. support training

It is unclear if the ‘active ingredient’ of child involvement influenced effectiveness because this was not tested.

The study included two different family-based interventions and about half of parents in each group reported a quit attempt since study enrolment

de Vries et al. [35]

Netherlands

Pregnant women who had been pregnant more than twice (because assumed that these women would be very unlikely to change their smoking behaviour) and smoked at least 1 cigarette a day

Partners who smoked were involved, otherwise partners not involved

The main target group (pregnant women) was a current smoker. If their partner also smoked then they were included in the intervention

141 and 177 pregnant women in intervention and control groups completed first questionnaires, respectively. Number of partners not given

None given

Self-reported: 7-day abstinence, Continuous abstinence (6 weeks postpartum), Partner smoking; Measures at pre-test and 6 weeks post-intervention and 6 weeks postpartum.

Urine-cotinine levels measured by gas

chromatography/mass spectrometry in sub-sample

Brief health counseling, self-help materials on smoking cessation during pregnancy and early postpartum, and a partner booklet vs. usual care and a general folder from the Dutch Smoking and Health Foundation

It is unclear if the ‘active ingredient’ of partner spouses’/partners’ involvement influenced effectiveness because this was not tested

The intervention was effective for pregnant women. Significant differences were found between the two groups. Nineteen percent of the experimental group reported 7-day abstinence compared to 7 % of the control group at first follow up, and 21 and 12 %, respectively, at second follow up. For continuous abstinence these percentages were 12 % in the experimental group and 3 % in the control group

The intervention was not effective for partners. No significant differences between the two groups were found for partners

Wood et al. [37]

European countries: France, Italy, Poland, Spain, Sweden, UK, Denmark, Italy,Poland, Spain, the Netherlands

Patients at least 50 years of age and less than 80 years old, with no history of cardiovascular disease but at risk of coronary heart disease with no history of severe heart failure, severe physical disability, or dementia and their partners

Spouse or partners

Smoking behaviour of the main target group (men at risk of coronary heart disease) and family members was not an eligibility criteria

1589 and 1499 patients with coronary heart disease in hospitals and 1189 and 1128 at high risk were assigned to intervention and usual care groups. 860 patients and 410 partners participated in hospital intervention programme; 947 high-risk patients and 204 partners participated in general practice intervention programme

Provide support

Self-reported cessation of smoking, validated by a breath carbon monoxide concentration of less than 6 parts per million; 12 months follow up

2 lifestyle intervention groups (hospital and general practice groups) vs. usual care (not described)

It is unclear if the ‘active ingredient’ of partner spouses’/partners’ involvement influenced effectiveness because this was not tested

The intervention was effective for patients Among patients with coronary heart disease who reported smoking in the month before their cardiac event, a higher proportion in the intervention group were not smokers at 1 year compared with the usual-care group (for example, hospital intervention vs. usual care was 58 % vs. 47 % p=0.06)

The intervention was not effective for partners. Non-smoking at 1 year was greater, although not significantly so, in the partners of patients in the intervention groups than in usual-care groups

  1. *Studies vary in how sample size is reported and we have used available information about adult smokers (target) and family members involved