Preventing Smoking Relapse During Pregnancy and Beyond

描述(由申请人提供)：吸烟的产前风险促使许多妇女在怀孕期间戒烟，并在几个月内保持戒烟。不幸的是，这些妇女中的大多数在怀孕期间或产后前六个月重新吸烟。恢复吸烟对吸烟者本身和暴露在环境烟草烟雾中的人，包括婴儿和其他家庭成员来说，与癌症和其他健康风险有关。由于如此多的女性能够在怀孕期间至少实现短期戒烟，怀孕和产后被集体视为“旨在防止吸烟复发的干预措施的机会之窗”。 虽然在帮助妇女在怀孕期间戒烟方面取得了一定的成功，但到目前为止，防止再次吸烟的尝试并不成功。研究I的目标是开发成本效益高的最小干预措施的关键材料，以防止孕妇/产后妇女再次吸烟。这种干预将仿照研究团队开发的一种干预方法，该方法已被发现可以在最近戒烟的普通人群中减少约三分之二的复吸率。这项干预措施包括一年多来邮寄给前吸烟者的八本戒烟小册子。这些小册子是基于对吸烟复发的理论和研究而开发的，被发现非常具有成本效益。然而，由于怀孕和产后妇女在许多方面与一般前吸烟者不同，不能假设现有的干预措施将充分满足她们的独特需求。 研究I的最终产品将是为怀孕六个月到产后八个月的妇女设计的一系列小册子，通常是永远免费的。小册子的内容将基于三个信息来源：(1)现有的有效戒烟手册，(2)怀孕期间和怀孕后吸烟复发的理论和研究，以及(3)系统的形成性研究，包括焦点小组、深入访谈和学习者验证访谈。研究对象将包括保持戒烟状态的孕妇和产后妇女，以及复发的妇女；她们的伴侣；以及社区中的相关卫生专业人员。 研究二将是研究一中开发的干预措施的随机对照试验。在怀孕期间戒烟的妇女将通过分娩教育课程被招募，并随机分配获得一系列永久免费的小册子，而不是通常的护理控制条件。将在产后12个月内进行随访，并进行形式成本效果分析。如果被证明是有效的，这种最低限度的干预将很容易并不昂贵地通过各种渠道和环境传播给妇女。

DESCRIPTION (provided by applicant): The prenatal risks of tobacco smoking motivate many women to quit smoking during pregnancy and to maintain abstinence for several months. Unfortunately, the majority of these women relapse to smoking either during their pregnancy or within the first six months postpartum. Resumption of smoking is associated with cancer and other health risks to the smokers themselves and to those exposed to their environmental tobacco smoke, including the infant and other members of the family. Because so many women are able to achieve at least short-term abstinence during their pregnancy, the pregnancy and postpartum periods are collectively viewed as a "window of opportunity for interventions designed to prevent smoking relapse. Although modest success has been achieved at aiding women in smoking cessation during pregnancy, attempts to prevent subsequent smoking relapse have been unsuccessful to date. The goal of Study I is to develop the key materials for a cost-effective minimal intervention preventing smoking relapse among pregnant/postpartum women. The intervention will be modeled after one developed by the research team that has been found to reduce smoking relapse by approximately two-thirds among a general population of recent quitters. This intervention comprises a series of eight Stay Quit booklets mailed to former smokers over a year. The booklets were developed based on theory and research on smoking relapse, and were found to be extremely cost-effective. However, because pregnant and postpartum women differ in many ways from the general population of ex-smokers, it cannot be assumed that the existing intervention would adequately meet their unique needs. The end product of Study I will be a series often Forever Free for Baby and Me booklets designed to be provided to women between their sixth month of pregnancy and eight months postpartum. The content of the booklets will be based on three sources of information: (1) the existing, validated Stay Quit booklets, (2) theory and research on smoking relapse during and after pregnancy, and (3) systematic formative research comprising focus groups, in-depth interviews, and learner verification interviews. Subjects will include pregnant and postparatum women who have maintained tobacco abstinence, as well as those who have relapsed; their partners; and relevant health professionals in the community. Study II will be a randomized, controlled trial of the intervention developed in Study I. Women who have quit smoking during pregnancy will be recruited via childbirth education classes and randomly assigned to receive the series of Forever Free booklets versus a usual care control condition. Follow up will be conducted through 12 months postpartum, and a format cost-effectiveness analysis wilt be conducted. If shown to be effective, this minimal intervention would be easy and inexpensive to disseminate to women via a variety of channels and settings.