‘LOVE MY LUNGS’ - A SMOKE-FREE HOME INTERVENTION FOR FAMILIES OF BABIES ADMITTED TO NEONATAL INTENSIVE CARE

Tobacco smoking has a severe detrimental impact on parental and child health. Pregnant women who smoke are more likely to give birth to a low birthweight or premature baby, requiring admission to neonatal intensive care (NICU). Preterm birth offers a ‘teachable moment’ to support parents to quit smoking, remain smokefree, and maintain smokefree environments. UK guidance recommends support for smoke-free strategies in secondary care settings during pregnancy and after childbirth, but interventions are not routinely offered in NICU.

This study took a theory-based approach to intervention development, being underpinned by a logic model derived from existing evidence and qualitative development work. Focus groups and interviews with parents and family members of babies admitted to NICUs (n=42) sought feedback on potential intervention approaches, considering ‘who’ might introduce, ‘what’ might be the content, and ‘when’ an intervention might be delivered. Focus groups with NICU healthcare professionals were also undertaken.

Parents were amenable to smoking cessation and surprised that it was not offered. Support might best be delivered by a NICU nurse with specialist training, reinforced by a Doctor or Consultant, taking a ‘whole unit’ approach. Support with cessation and relapse prevention through information about smoke-free homes, and support to use nicotine in less harmful ways were identified as important. Parents wanted health messages to be hard hitting, give factual advice about the harms of smoking on vulnerable infants specifically, come from the perspective of the baby, and wanted information to be delivered in novel ways.

A complex intervention comprising staff training to facilitate active acknowledgement of smoking status of parents of babies on NICU, timely support, and educational messages delivered by innovative virtual reality (VR) short clips is presented. The intervention will be made widely available across UK NICUs with ongoing implementation evaluation.