Development of a smoke-free home intervention for families of babies admitted to neonatal intensive care

Caitlin Notley, Tracey Brown, Linda Bauld, Elaine Boyle, Paul Clarke, Wendy Hardeman, Richard Holland, Marie Hubbard, Felix Naughton, Amy Nichols, Sophie Orton, Michael Ussher, Emma Ward

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Neonatal intensive care units (NICUs) have a disproportionately higher number of parents who smoke tobacco compared to the general population. A baby’s NICU admission offers a unique time to prompt behaviour change, and to emphasise the dangerous health risks of en-vironmental tobacco smoke exposure to vulnerable infants. We sought to explore the views of mothers, fathers, wider family members, and healthcare professionals to develop an intervention to promote smoke-free homes, delivered on NICU. This article reports findings of a qualitative interview and focus group study with parents whose infants were in NICU (n=42) and NICU healthcare professionals (n=23). Thematic analysis was conducted to deductively explore aspects of intervention development including initiation, timing, components and delivery. Analysis of inductively occurring themes was also undertaken. Findings demonstrated that both parents and healthcare professionals supported the need for intervention. They felt it should be positioned around the promotion of smoke-free homes, but to achieve that end goal might incorporate direct cessation support during the NICU stay, support to stay smoke free (relapse prevention), and support and guidance for discussing smoking with family and household visitors. Qualitative analysis mapped well to an intervention based around the ‘3As’ approach (Ask, Advise, Act). This informed a logic model and intervention pathway.
Original languageEnglish
Article number3670
JournalInternational Journal of European Research in Public Health
Issue number6
Publication statusPublished - 19 Mar 2022


  • Intervention development
  • Neonatal
  • Relapse prevention
  • Smoke-free homes
  • Smoking cessation

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