SMOKING RELAPSE PREVENTION FOR PREGNANT WOMEN

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During the past decade, numerous reports have confirmed the detrimental effects of smoking during pregnancy on the health of the fetus, newborn infant, and the mother. More recently, efforts are being made to increase the awareness and to inform both the mother and the physician about the effects of smoking during pregnancy. These public information campaigns and warnings appear to be motivating some women to attempt to quit smoking once becoming pregnant (approximately 20-25%). It is apparent from early work, however, a significant problem exists in the resumption of smoking following successful cessation. Efforts need to be directed toward providing these motivated women with experiences to encourage continued success during pregnancy. No programs are currently available to assist the pregnant ex- smoker in not relapsing. The purpose of this project is to develop a multi-component intervention to prevent smoking relapse among pregnant women in Public Health Maternity clinics. We will evaluate the effectiveness of an intervention composed of three principal components: 1) a ten minute standardized relapse prevention skill training session, 2) social support, and 3) clinic reinforcement. A randomized, perspective pretest/post-test group design will be employed to evaluate the effectiveness. A total of 110 recent quitters will be randomized to the two groups and then be followed until the end of pregnancy. Self-reports of abstinence will be verified using carbon monoxide testing. We are seeking new, critical information in this formative evaluation on: 1) what type of program will fit into a busy prenatal care clinic (feasibility) and 2) the level of effectiveness these methods might have (behavioral impact). With this information, we will be able to estimate intervention effects and be in an excellent position to propose a larger, more rigorous trial to address this significant problem of recidivism among pregnant women at high risk.