The role of nurses and midwives in preventing smoking among pregnant women: An intervention study

Main objective of the study is to give training to nurses and midwives in order to improve their skills in prevention of smoking among pregnant women.
For this intervention study, seven health centers in a large district were randomly selected, stratified by socioeconomic level and all pregnant women who were on the fourth month have been recruited from these centers (n=307). Three centers have been randomized to intervention group and four centers to control group which had 40 midwives and nurses, included in the study.
At baseline, a questionnaire was applied to pregnant women to determine the prevalence of smoking and another to investigate the skills and attitudes of nurses and midwives about smoking counseling. A short training program, on smoking counseling was implemented to the intervention group. Second questionnaire was given to nurses and midwives after five months to see the change in attitude and skills. In order to assess the effect of counseling, the smoking information of pregnant women has been collected in three months period after the delivery.
The intervention and control groups were similar in skill and attitude scores and proper counseling attitudes at baseline.  Pregnant women in both groups had similar smoking prevalence (20 %). The 53.3 % of pregnant women in intervention group and 46.2 % in control group were passive smokers at their home.  
After training the counseling attitude scores of intervention group (midwives and nurses) were significantly higher than the control group. Although, counseling scores were higher in intervention group, no significant difference has been detected. Rates of smoking and passive smokers decreased during the subsequent interview but it was not statistically significant.  In conclusion, the attitudes of the nurse and midwifes have improved significantly after the intervention however, change in behavior was not observed.