SMOKING CESSATION DURING OBSTETRIC CARE

这项提案的目标是降低慢性病的发病率 肺部疾病和其他与香烟有关的疾病 将戒烟计划纳入产前护理 提供给低收入人口。这次会议的主要目标是 建议是：1)降低吸烟的流行率 在产前护理期间的妇女中；2)减少 戒烟妇女孕期吸烟复发 在第一次产前检查之前；以及3)减少 婴儿出生后，吸烟又复发了。 戒烟和预防复发的建议将由 医生得到更具体的建议和咨询的支持 由戒烟顾问提供。戒烟 医生的建议将根据妇女的水平量身定做 打算在怀孕期间戒烟。吸烟 戒烟顾问将制定戒烟计划，排练 并提供必要的技能和支持材料。医生的 建议和辅导员支持将在每个第一个 三次产前检查。辅导员将提供额外的 在常规诊所之间通过电话、邮件和家访联系 来访。进一步努力促进戒烟或 保持节欲将在怀孕第36周开始。 吸烟行为将通过自我报告和尿液进行评估 可替宁在研究开始时和在第36周和通过自我 产后三个月报告和唾液可替宁。呼出 在产前检查中测量的一氧化碳浓度将 为医生提供吸烟行为的指示，以便 用于在这些时间提供反馈。 这个项目将利用我们在病人方面的技能和经验 教育、戒烟的行为方法、医生 培训和项目评估。

The goal of this proposal is to reduce the prevalence of chronic lung disease and other cigarette related illnesses through a smoking cessation program integrated into the prenatal care provided to a low income population. The major objectives of this proposal are: 1) to reduce the prevalence of cigarette smoking among women during prenatal care; 2) to reduce the incidence of smoking relapse during pregnancy among women who stop smoking prior to their first prenatal visit; and 3) to reduce the incidence of smoking relapse after the baby is born. Smoking cessation and relapse prevention advice will be given by physicians supported by more specific advice and counseling provided by smoking cessation counselors. The smoking cessation advice from the physicians will be tailored to the woman's level of intentions to stop smoking during the pregnancy. The smoking cessation counselors will work out plans to quit smoking, rehearse necessary skills and provide supportive materials. Physicians' advice and counselor support will be provided at each of the first three prenatal visits. The counselors will provide additional contact by phone, mail and home visits between the regular clinic visits. Further efforts to promote smoking cessation or to maintain abstinence will be made a the 36th week of pregnancy. Smoking behavior will be assessed by self-report and urinary cotinine at entry to the study and at the 36th week and by self- report and salivary cotinine three months after delivery. Exhaled carbon monoxide concentration, measured at prenatal visits, will provide an indication of smoking behavior for the physicians to use to provide feedback at these times. This project will draw on our skill and experience in patient education, behavioral approaches to smoking cessation, physician training, and program evaluation.