SMS scheduled gradual reduction text messages to help pregnant smokers quit

怀孕期间吸烟对胎儿和母亲的健康构成严重威胁。不幸的是，大约一半的妇女在怀孕时继续吸烟；这一比例在过去十年中并没有显著下降。显然，有效的干预是必要的。有希望的是，大多数女性在得知怀孕后会减少吸烟，大多数人表示希望通过减少吸烟来戒烟，而不是直接戒烟。然而，自我断奶往往是无效的，并破坏了完全戒烟的努力。计划逐步减量(SGR)可能是促进孕妇戒烟的一种有效方法。SGR与认知行为咨询一起，已被证明可以帮助非怀孕吸烟者戒烟，而不是戒烟或自我断奶。理想情况下，SGR可以通过短信之类的方式传递，这是大多数怀孕吸烟者都熟悉的。我们的试点工作表明了这一SGR CBT计划的可行性、可接受性和初步效果。这项工作的最终产品将是一个可传播的、随时可以实施的方案。这项拟议的为期五年的研究旨在评估SGR加CBT通过短信在不同种族的怀孕吸烟者中促进戒烟的效果。提出了一种双臂随机对照设计。符合条件的孕妇(N=522，每臂261人)将被随机分为：ARM 1，通过短信加短信支持信息和自助材料的SGR(n=261)或ARM 2，短信支持信息和自助材料(n=261)。主要的结果衡量标准是在怀孕结束时经过生化验证的7天点普遍禁欲。次要结果是在怀孕结束时长期戒烟，在怀孕期间生物化学验证的吸烟减少，在产后3个月戒烟，以及早产。这个项目的意义在于，没有任何易于传播的有效方案来帮助孕妇戒烟。一种自动化的、量身定做的短信干预措施显示，有望接触到许多孕妇，并在怀孕期间减少吸烟。

Smoking in pregnancy poses serious health risks to the fetus and mother. Unfortunately, about half of women continue to smoke when becoming pregnant; this rate has not decreased significantly in the past decade. Effective interventions clearly are needed. Promisingly, most women reduce smoking when learning of their pregnancy, and most report desiring to quit via reduction rather than cold turkey. However, self-weaning often is ineffective and undermines total cessation efforts. Scheduled gradual reduction (SGR) might be an effective way to promote cessation among pregnant women. SGR, along with cognitive behavioral counseling, has been shown to help non-pregnant smokers quit above cold turkey or self-weaning methods. SGR might be ideally delivered via a method like SMS text messaging, with which most pregnant smokers are familiar. Our pilot work shows feasibility, acceptability, and preliminary efficacy of this SGR + CBT program. The end product of this work would a disseminable ready-to-be-implemented program. The proposed five-year study is designed to evaluate the efficacy of SGR plus CBT via SMS text messaging in promoting smoking cessation among a racially diverse sample of pregnant smokers. Proposed is a two-arm randomized controlled design. Eligible pregnant women (N=522, 261 per arm) will be randomized to: Arm 1, SGR via SMS text messaging plus SMS Support Messages and self-help materials (n=261) or Arm 2, SMS Support Messages and self-help materials (n=261). The primary outcome measure is biochemically validated 7-day point prevalent abstinence at the end of pregnancy. Secondary outcomes are prolonged abstinence at the end of pregnancy, biochemically-validated smoking reduction during pregnancy, smoking abstinence at 3-months postpartum, and preterm birth. The significance of this project is that no easily disseminable effective programs exist to help pregnant women quit smoking. An automated, tailored text messaging intervention shows promise to reach many pregnant women and reduce smoking during pregnancy.