Smoking Relapse Prevention Among Postpartum Women

怀孕期间戒烟的妇女产后复发率极高（即，产后2-3个月时约为45%，6个月时为60- 70%，1年时高达80%）。 这些产后复发率高是令人惊讶的，因为它们发生在大多数妇女在分娩前禁欲7-9个月的人群中。 因此，促进母亲长期戒烟以及减少吸烟对其子女的有害影响的巨大公共卫生机会没有得到充分实现。该项目的总体目标是开发和评估一种“动机性复吸预防”（MRP）治疗方法，以减少怀孕期间戒烟的妇女产后复吸。MRP将利用一种动机增强方法，专门针对增加承诺和维持产后禁欲的内在动机，复发预防理论结构（即，自我效能、结果预期、应对行为），以及与产后妇女特别相关的问题（例如，负面影响，压力，社会支持，体重问题）。治疗将以电话为基础，并设计为易于传播到基于人口的烟草控制环境（例如，州戒烟热线、卫生保健系统）。 此外，该项目还将评估MRP的成本效益。参与者（N=400）将被随机分配到两组之一：1）标准复发预防，或2）MRP。 MRP将包括六个电话咨询电话，以及专为产后期设计的复发预防自助材料。 产后评估将在第8、26和52周进行。

Postpartum relapse rates among women who quit smoking during pregnancy are exceedingly high (i.e., approximately 45 percent at 2-3 months postpartum, 60-70 percent at 6 months, and up to 80 percent at one year). These high rates of postpartum relapse are surprising because they occur in a population where the majority of women have been abstinent for 7-9 months prior to giving birth. Thus, the tremendous public health opportunity to facilitate long-term abstinence from tobacco among mothers as well as reduce the detrimental effects on smoking on their children is not being fully realized. The overall aim of this project is to develop and evaluate a "Motivational Relapse Prevention" (MRP) treatment for reducing postpartum smoking relapse among women who quit during pregnancy. MRP will utilize a motivational enhancement approach that specifically targets increasing commitment and intrinsic motives for maintaining postpartum abstinence, relapse prevention theory constructs (i.e., self-efficacy, outcome expectancies, coping behavior), and issues of particular relevance to postpartum women (e.g., negative affect, stress, social support, weight concerns). Treatment will be telephone-based and is designed to be easily disseminated to population-based settings for tobacco control (e.g., state quitlines, health care systems). In addition, the project will assess the cost-effectiveness of MRP. Participants (N=400) will be randomly assigned to one of two groups: 1) Standard Relapse Prevention, or 2) MRP. MRP will consist of six telephone counseling calls, and relapse prevention self-help materials designed specifically for the postpartum period. Postpartum assessments will occur at weeks 8, 26, and 52.