Smoking relapse prevention during pregnancy. A trial of coordinated advice from physicians and individual counseling.
Smoking relapse prevention during pregnancy. A trial of coordinated advice from physicians and individual counseling.
复制标题
怀孕期间预防吸烟复吸。
DOI：
10.1016/s0749-3797(98)00029-4
复制
发表时间：
1998
影响因子：
5.5
通讯作者：
Mead,PB
中科院分区：
文献类型：
--
作者：
Secker-Walker,RH;Solomon,LJ;Flynn,BS;Skelly,JM;Mead,PB
IntroductionOur objective was to examine efficacy of physician ' advice and referral to individual counseling in preventing retrieval to smoking among women who were smokers early in pregnancy，but quit before their first产前visiting.DesignA randomized controlled trial of prompted physician's advice and individual retrieval prevention counseling during pregnancy compared to usual physicians advice.吸烟状况进行了评估，自我报告，呼出的一氧化碳，尿可替宁在怀孕期间和自我报告1年postparty.ResultsThere复发率之间的干预和常规护理组在怀孕期间，也没有显着差异产后1年。两组在36周随访时的复发率分别为23%，产后1年分别为32%和22%。年龄较小、恢复吸烟的动机较高以及首次产前访视时呼出的一氧化碳水平较高是怀孕期间吸烟复发的预测因素。保守地假设所有失访者都复发了，产后1年的复发率为51%，比我们在早期复发预防试验中观察到的低17个百分点，与十年前全国范围内观察到的结果相比，降低了15个百分点。结论：让医生提供支持性建议并推荐个人预防复发咨询并不能减少吸烟怀孕期间或产后的复发率。然而，在怀孕期间，干预组和常规护理组的医生对吸烟的关注程度可能导致产后1年的复发率相对较低。
IntroductionOur objective was to examine the efficacy of physicians’ advice and referral to individual counseling in preventing relapse to smoking among women who were smokers early in pregnancy, but quit prior to their first prenatal visit.DesignA randomized controlled trial of prompted physician’s advice and individual relapse prevention counseling during pregnancy compared to usual physician advice. Smoking status was assessed by self-report, exhaled carbon monoxide, and urinary cotinine during pregnancy and by self-report 1 year postpartum.ResultsThere were no significant differences in relapse rates between the intervention and usual-care groups during pregnancy, nor at 1 year postpartum. Relapse rates were 23% in both groups at the 36-week visit, and 32% and 22%, respectively, 1 year postpartum. Younger age, higher motivation to resume smoking, and higher levels of exhaled carbon monoxide at the first prenatal visit were predictive of relapse to smoking during pregnancy. With the conservative assumption that all those lost to follow-up relapsed, the combined 1-year postpartum relapse rate, 51%, was 17 percentage points lower than we observed in an earlier relapse prevention trial, and 15 percentage points lower than that observed nationally a decade earlier.ConclusionPrompting physicians to provide supportive advice combined with referral to individual relapse prevention counseling did not reduce smoking relapse rates during pregnancy, or postpartum. However, the level of attention paid to smoking by physicians in both intervention and usual-care groups during pregnancy may have contributed to the relatively low relapse rates seen 1-year postpartum.