Tailoring a NICU-Based Tobacco Treatment Program for Mothers Who Are Dependent on Opioids

Abstract

Objective To collect formative information to design a tailored tobacco treatment intervention for women with newborns treated or evaluated for neonatal abstinence syndrome and to explore current tobacco use behaviors and facilitators and barriers to smoking cessation. Design Qualitative descriptive study. Setting An academic medical center in the southern United States. Participants Mothers of newborns who were treated or evaluated for neonatal abstinence syndrome at birth within the preceding three months. Women were recruited who were older than 18 and reported opioid dependence and smoking during pregnancy. Methods Participants took part in semi-structured individual interviews that lasted approximately one hour. Interviews were professionally transcribed and analyzed in MAXQDA using content analysis. Results Five themes emerged from the data: Strategizing to Reduce Risk, Desire to Quit Smoking in the Future; Holding on to Smoking While Working Through Recovery, Feeling Judged by Nurses, and Feeling Supported And Empowered By Nurses. Participants reported planning to reduce risk to their newborns by avoiding secondhand and thirdhand smoke exposure. Participants wanted to stop smoking but reported many barriers, including multiple life stressors compounded by their newborns’ extended stays in the hospital. However, most participants described overall positive experiences and the support of health care providers. Conclusions Holistic tobacco treatment programs that incorporate stress relief and social support and are led by trusted health care providers have the potential to be effective to reduce smoking in new mothers with histories of opioid dependence disorders and smoking and whose newborns are in the NICU.

Health Care Encounters of Pregnant and Postpartum Women with Substance Use Disorders

“…During encounters with health care providers, many pregnant and postpartum with SUDs women feel judged because of their substance use. (Cleveland & Bonugli, 2014;Cleveland & Gill, 2013;Demirci et al, 2015;Fallin-Bennett & Ashford, 2017;Kramlich et al, 2018;Mattocks et al, 2017;McGlothen et al, 2018;Paterno et al, 2018;Roberts & Nuru-Jeter, 2010;Salmon et al, 2000;Suarez et al, 2018) .50…”

“…Some pregnant and postpartum women with SUDs have positive relationships with their health care providers and feel the providers do not judge or treat the women differently than women without SUDs. (Cleveland & Bonugli, 2014;Cleveland & Gill, 2013;Fallin-Bennett & Ashford, 2017;Howard 2015;Kramlich et al, 2018;Mattocks et al, 2017;Roberts & Nuru-Jeter, 2010;Salmon et al, 2000;Stone, 2015;Suarez et al, 2018) .41…”

“…Some pregnant and postpartum women with SUDs feel health care providers provide good medical care, emotional support, and helpful health-related information. (Demirci et al, 2015;Fallin-Bennett & Ashford, 2017;Hicks 2018;Howard, 2016; .39…”

“…Pregnant and postpartum women with SUDs feel nurses monitor the women when they are with their infants or take over the infants' care. (Cleveland et al, 2016;Cleveland & Bonugli, 2014;Cleveland & Gill, 2013;Demirci et al, 2015;Fallin-Bennett & Ashford, 2017;Howard, 2015;Kramlich et al, 2018;McGlothen et al, 2018;Salmon et al, 2000;Stone 2015) .36…”

“…Some pregnant and postpartum women with SUDs feel that health care providers give good care of their infant. (Cleveland & Bonugli, 2014;Fallin-Bennett & Ashford, 2017;Mattocks et al, 2017;McGlothen et al, 2018;Salmon et al, 2000;Suarez et al, 2018) .26…”