Smoking Relapse Prevention Among Postpartum Women

在怀孕期间戒烟的妇女的产后复发率非常高（即，产后2-3个月约为45%，6个月约为60- 70%，一年后高达80%）。如此高的产后复发率令人惊讶，因为大多数妇女在分娩前已经禁欲了7-9个月。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尚未充分实现。该项目的总体目标是开发和评估“动机性复发预防”（MRP）治疗方法，以减少在怀孕期间戒烟的妇女的产后吸烟复发。MRP将利用一种动机增强方法，专门针对增加维持产后戒断的承诺和内在动机，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，目的是便于传播到以人口为基础的烟草控制环境（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，以及专门为产后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.