Screening |
Date of birth, expected due date of delivery, gestational age at screening, smoking status |
x |
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Informed consent |
Patient information and consent form, photograph for identification purposes |
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x |
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Demographics |
Aboriginal and Torres Strait Islander status, education, income status, marital status, current living arrangements |
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x |
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Smoking and household smoking |
Number of household smokers, house and car smoking bans, changes to smoking during pregnancy, types of tobacco used, number of cigarettes smoked, Fagerström Test for Cigarette Dependence,107 strength and frequency of urges to smoke, feelings about smoking, history of quit attempts, methods previously used to quit |
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x |
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Childhood Trauma Questionnaire (CTQ)108
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28-item assessment of five types of childhood trauma: physical, sexual and emotional abuse; physical and emotional neglect |
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x |
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Alcohol Use Disorders Identification Test (AUDIT-C)109
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3-item screen identifying hazardous drinking or alcohol use disorder |
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x |
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x |
x |
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Australian Treatment Outcomes Profile (ATOP)110
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Screens 28-day use of a range of substances, health and well-being, housing, employment and study, violence, legal issues, child protection |
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x |
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x |
x |
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Generalized Anxiety Disorder (GAD-7)111
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7-item screening and severity measure of generalised anxiety disorder |
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x |
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x |
x |
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Patient Health Questionnaire (PHQ-9)112
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9-item screening, monitoring and severity measure of depression |
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x |
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x |
x |
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Treatment Acceptability Questionnaire |
13 items adapted from prior internet-based contingency management studies.72 Assesses acceptability and helpfulness of study components |
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x |
x |
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Counselling |
Mode of delivery, phase and major topics of discussion, importance of quitting, confidence to quit |
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x |
Nicotine replacement therapy (NRT) |
Quantity of NRT used in past 7 days, concerns or problems using NRT, household member use of NRT |
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x |
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x |
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7-day smoking status |
Self-reported 7-day point prevalence abstinence and number of cigarettes smoked |
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x |
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x |
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Expired air CO |
CO ppm |
x |
x |
x |
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x |
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