STUDY PROTOCOLS
An mHealth intervention to prevent postnatal smoking relapse: The RESPREMO study protocol
Marina Dascal 1, 2
,  
Andreea Rusu 1, 2  
,  
Alexandra Onisor 1, 2
,  
Oana Blaga 1, 2
,  
Cristian Meghea 1, 2, 4
 
 
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1
Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
2
Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj- Napoca, Romania
3
College of Human Medicine, Michigan State University, East Lansing, United States
4
Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, United States
CORRESPONDING AUTHOR
Andreea Rusu   

Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, 400376, Romania
Publication date: 2020-04-14
Submission date: 2020-01-06
Final revision date: 2020-02-28
Acceptance date: 2020-03-03
 
Tob. Prev. Cessation 2020;6(April):24
KEYWORDS
TOPICS
ABSTRACT
Up to 70% of women who quit smoking relapse after birth, usually within 3 months postpartum. The wide adoption of mobile technologies, especially smartphones, in recent years in low- and middle-income countries (LMICs) offers the possibility of low-cost, novel, and innovative mobile phone-based interventions for smoking relapse prevention. This study presents the protocol of the RESPREMO clinical trial for postnatal smoking relapse prevention for enrolled women, who recently gave birth and quit tobacco smoking before or during pregnancy, and their life partners. This work relies on data collected in two of the largest government-owned obstetrics and gynecology clinics in Cluj-Napoca, Romania. Seventy-five couples were randomized into one of three groups: a) 24 couples were allocated to the first intervention group and asked to install and use the xSmoker app; b) 26 couples were randomized to the second intervention group, who, in addition to the use of the xSmoker app, received text messages with content focused on motivation, problem solving, and dyadic efficacy; and c) 25 couples were randomized into a control group. Several measures of engagement with the xSmoker app were assessed, including duration of app use, the frequency of utilizing the tool to calculate savings from quitting, number of app-delivered challenges accepted by users, and number of app-delivered cessation and abstinence tips. If effective, RESPREMO is expected to have a sustainable impact on the prevention of postnatal relapse tobacco smoking with positive effects for both the mother and the newborn. The implications are beyond tobacco control, and relevant to the design and implementation of other mHealth behavioral interventions focused on the pregnancy and reproductive years in general.
CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
This work was supported by a grant of the Ministry of Research and Innovation, CNCS-UEFISCDI, project number PN-III-P4-ID-PCE-2016-0632, within PNCDI III.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
REFERENCES (26)
1.
World Health Organization. WHO report on the global tobacco epidemic 2019. https://www.who.int/tobacco/gl.... Accessed January 6, 2020.
 
2.
Keegan J, Parva M, Finnegan M, Gerson A, Belden M. Addiction in Pregnancy. J Addict Dis. 2010;29(2):175-191. doi:10.1080/10550881003684723
 
3.
Meghea CI, Rus D, Rus IA, Summers Holtrop J, Roman L. Smoking during pregnancy and associated risk factors in a sample of Romanian women. Eur J Public Health. 2012;22(2):229–233. doi:10.1093/eurpub/ckq189
 
4.
Al-Sahab B, Saqib M, Hauser G, Tamim H. Prevalence of smoking during pregnancy and associated risk factors among Canadian women: a national survey. BMC Pregnancy Childbirth. 2010;10(1):24. doi:10.1186/1471-2393-10-24
 
5.
World Health Organization. Global adult tobacco survey: Romania 2018. Geneva, Switzerland: World Health Organization; 2018.
 
6.
Blaga OM, Brînzaniuc A, Rus IA, Cherecheș RM, Wallis AB. Smoking and Smoking Cessation During Pregnancy. An Analysis of a Hospital Based Cohort of Women in Romania. J Community Health. 2017;42(2):333–343. doi:10.1007/s10900-016-0259-6
 
7.
Winickoff JP, Healey EA, Regan S, et al. Using the postpartum hospital stay to address mothers’ and fathers’ smoking: the NEWS study. Pediatrics. 2010;125(3):518–525. doi:10.1542/peds.2009-0356
 
8.
Schneider S, Huy C, Schuetz J. Smoking cessation during pregnancy: a systematic literature review. Drug alcohol. 2010;29(1):81-90. doi:10.1111/j.1465-3362.2009.00098.x
 
9.
Meghea CI, Rus IA, Rus D. Risk factors associated with nicotine dependence in a sample of Romanian pregnant smokers. Eur J Obstet Gynecol Reprod Biol. 2012;163(1):22–26. doi:10.1016/j.ejogrb.2012.03.033
 
10.
Sterba KR, Rabius V, Carpenter MJ, Villars P, Wiatrek D, McAlister A. Dyadic Efficacy for Smoking Cessation: Preliminary Assessment of a New Instrument. Nicotine Tob Res. 2011;13(3):194–201. doi:10.1093/ntr/ntq236
 
11.
Lopéz DM, Blobel B. MHealth in low- and middle-income countries: Status, requirements and strategies. Stud Health Technol Inform. 2015;211:79–87. PMID:25980851.
 
12.
Kaplan WA. Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries? Global Health. 2006;2(1):9. doi:10.1186/1744-8603-2-9
 
13.
Marcolino MS, Oliveira JAQ, D’Agostino M, Ribeiro AL, Alkmim MBM, Novillo-Ortiz D. The Impact of mHealth Interventions: Systematic Review of Systematic Reviews. JMIR mHealth uHealth. 2018;6(1):e23. doi:10.2196/mhealth.8873
 
14.
GSM Association. Ericsson Mobility Report: On the pulse of the Networked Society. https://www.gsma.com/latinamer.... Published August 30, 2013. Accesses January 6, 2020.
 
15.
Hajek P, Stead LF, West R, Jarvis M, Hartmann-Boyce J, Lancaster T. Relapse prevention interventions for smoking cessation. Cochrane database Syst Rev. 2013;8:CD003999. doi:10.1002/14651858.CD003999.pub4
 
16.
Reitzel LR, Vidrine JI, Businelle MS, et al. Preventing postpartum smoking relapse among diverse low-income women: a randomized clinical trial. Nicotine Tob Res. 2010;12(4):326–335. doi:10.1093/ntr/ntq001
 
17.
Lumley J, Chamberlain C, Dowswell T. Interventions for promoting smoking cessation during pregnancy. Database Syst Rev. 2009;(3):CD001055. doi:10.1002/14651858.CD001055.pub3
 
18.
Hemsing N, Greaves L, O’Leary R. Partner support for smoking cessation during pregnancy: a systematic review. Nicotine Tob. 2011;14(7):767-776. doi:10.1093/ntr/ntr278
 
19.
McBride CM, Baucom DH, Peterson BL, et al. Prenatal and postpartum smoking abstinence a partner-assisted approach. Am J Prev Med. 2004;27(3):232–238. doi:10.1016/j.amepre.2004.06.005
 
20.
Abroms LC, Lee Westmaas J, Bontemps-Jones J, Ramani R, Mellerson J. A content analysis of popular smartphone apps for smoking cessation. Am J Prev Med. 2013;45(6):732–736. doi:10.1016/j.amepre.2013.07.008
 
21.
Clinical Practice Guideline Treating Tobacco Use and Dependence 2008 Update Panel, Liaisons, and Staff. A clinical practice guideline for treating tobacco use and dependence: 2008 update. A U.S. Public Health Service report. Am J Prev Med. 2008;35(2):158-176. doi:10.1016/j.amepre.2008.04.009
 
22.
Tombor I, Beard E, Brown J, Shahab L, Michie S, West R. Randomized factorial experiment of components of the SmokeFree Baby smartphone application to aid smoking cessation in pregnancy. Transl Behav Med. 2018;9(4):583-593. doi:10.1093/tbm/iby073
 
23.
Efird J. Blocked randomization with randomly selected block sizes. Int J Environ Res Public Health. 2011;8(1):15–20. doi:10.3390/ijerph8010015
 
24.
Brinzaniuc A, Strilciuc A, Blaga OM, Chereches RM, Meghea CI. Smoking and quitting smoking during pregnancy: A qualitative exploration of the socio-cultural context for the development of a couple-based smoking cessation intervention in Romania. Tob Prev Cessation. 2018;4(March). doi:10.18332/tpc/86161
 
25.
Meghea C, Brinzaniuc A, Sidor A, Chereches R, Mihu D, Iuhas C, et al. A couples-focused intervention for smoking cessation during pregnancy: The study protocol of the Quit Together pilot randomized controlled trial. Tob Prev Cessation. 2018;4(May). doi:10.18332/tpc/89926
 
26.
Witkiewitz K, Marlatt GA. Relapse prevention for alcohol and drug problems: that was Zen, this is Tao. Am Psychol. 59(4):224–235. doi:10.1037/0003-066X.59.4.224
 
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