Adapting and Evaluating a Culturally Sensitive Smoking Cessation Intervention for Socioeconomically Disadvantaged Pregnant Women in Germany: A Feasibility Study
1
Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
2
Faculty of Health, Southern Cross University, Coffs Harbour, Australia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Smoking during pregnancy and exposure to second-hand smoke remain major public health concerns, particularly among socioeconomically disadvantaged families. These behaviours increase the risk of adverse maternal and child health outcomes and contribute to long-term non-communicable diseases such as cancer. The Supporting Indigenous Smokers to Assist Quitting (iSISTAQUIT) program, originally developed for Aboriginal and Torres Strait Islander women in Australia, provides culturally tailored, evidence-based cessation support. This study aims to evaluate the feasibility and acceptability of an adapted iSISTAQUIT intervention in the German maternal health context.
METHODS:
A six-month non-randomised feasibility trial will be conducted with approximately 20 pregnant women and 12 midwives across midwifery centres and the ProKind early intervention programme in Bremen, Germany. Midwives will receive structured training on the “Ask, Brief advice, Cessation support, Discuss psychosocial context” (ABCD) approach and deliver personalised smoking cessation support using culturally adapted iSISTAQUIT and Smoke-Free Homes materials. Quantitative data from pre- and post-intervention surveys and carbon monoxide validation will be complemented by qualitative feedback from focus groups. Implementation will be assessed using the Practical, Robust Implementation and Sustainability Model (PRISM).
RESULTS:
The study will report recruitment and retention rates, intervention acceptability, and midwives’ changes in knowledge and confidence. Preliminary outcomes will include participants’ smoking behaviour changes, perceived support, and household smoke-free rule adoption. Qualitative insights will identify contextual and organisational factors influencing implementation.
CONCLUSIONS:
This study will provide the first evidence on the feasibility of implementing a culturally sensitive smoking cessation intervention for disadvantaged pregnant women in Germany. Findings will inform a larger trial and help reduce tobacco-related health inequities, advance maternal and child health, and support the integration of evidence-based, culturally adapted interventions into the health system.
Smoking during pregnancy and exposure to second-hand smoke remain major public health concerns, particularly among socioeconomically disadvantaged families. These behaviours increase the risk of adverse maternal and child health outcomes and contribute to long-term non-communicable diseases such as cancer. The Supporting Indigenous Smokers to Assist Quitting (iSISTAQUIT) program, originally developed for Aboriginal and Torres Strait Islander women in Australia, provides culturally tailored, evidence-based cessation support. This study aims to evaluate the feasibility and acceptability of an adapted iSISTAQUIT intervention in the German maternal health context.
METHODS:
A six-month non-randomised feasibility trial will be conducted with approximately 20 pregnant women and 12 midwives across midwifery centres and the ProKind early intervention programme in Bremen, Germany. Midwives will receive structured training on the “Ask, Brief advice, Cessation support, Discuss psychosocial context” (ABCD) approach and deliver personalised smoking cessation support using culturally adapted iSISTAQUIT and Smoke-Free Homes materials. Quantitative data from pre- and post-intervention surveys and carbon monoxide validation will be complemented by qualitative feedback from focus groups. Implementation will be assessed using the Practical, Robust Implementation and Sustainability Model (PRISM).
RESULTS:
The study will report recruitment and retention rates, intervention acceptability, and midwives’ changes in knowledge and confidence. Preliminary outcomes will include participants’ smoking behaviour changes, perceived support, and household smoke-free rule adoption. Qualitative insights will identify contextual and organisational factors influencing implementation.
CONCLUSIONS:
This study will provide the first evidence on the feasibility of implementing a culturally sensitive smoking cessation intervention for disadvantaged pregnant women in Germany. Findings will inform a larger trial and help reduce tobacco-related health inequities, advance maternal and child health, and support the integration of evidence-based, culturally adapted interventions into the health system.
| eISSN: | 2654-1459 |
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