Addressing Postpartum Mood and Weight Concerns to Sustain Smoking Cessation

描述（由申请人提供）： 大多数在怀孕期间戒烟的妇女在产后第一年会复发，产后吸烟对母亲和孩子的健康都有有害影响。例如，吸烟增加了妇女患某些癌症、呼吸道症状和生殖并发症的风险，接触烟草烟雾与婴儿猝死综合症、耳部感染、呼吸道疾病和儿童哮喘有关。以前旨在解决产后吸烟问题的干预措施并没有成功地提高产后持续戒烟率。然而，我们的研究已经证明，情绪和体重问题与产后吸烟复发有关，试点数据支持在产后期间解决情绪和体重问题的策略的可接受性。因此，本申请提出了一种新的认知行为产后复发预防计划的随机对照试验，该计划解决了在复发风险高的产后期间交付的妇女的情绪和体重问题。已戒烟并有兴趣在产后戒烟的孕妇（N = 300）将被随机分配到：1）针对情绪和体重问题的复发预防干预，或2）旨在控制治疗时间和注意力影响的非指导性支持性条件。我们假设干预组的妇女在产后6个月和12个月复发的可能性低于支持性条件下的妇女。我们还将研究治疗反应的介导者和调节者。这项调查的结果将提供有关认知行为复吸预防干预措施的有效性的信息，该干预措施结合了解决情绪和体重问题的策略，以防止吸烟复吸，并为未来关于预防产后吸烟和其他药物使用的研究提供信息。

DESCRIPTION (provided by applicant): The majority of women who quit smoking during pregnancy will relapse during the first year postpartum, and postpartum smoking has deleterious effects on the health of both the mother and her children. For example, smoking increases the risk of certain cancers, respiratory symptoms and reproductive complications among women, and exposure to tobacco smoke has been linked to sudden infant death syndrome, ear infections, respiratory illness and asthma among children. Previous interventions designed to address postpartum smoking have not successfully increased rates of sustained abstinence postpartum. However, our research has documented that mood and weight concerns are associated with postpartum smoking relapse, and pilot data support the acceptability of strategies to address mood and weight concerns in the postpartum period. Thus, this application proposes a randomized controlled trial of a novel, cognitive behavioral postpartum relapse prevention program that addresses women's mood and weight concerns delivered during the postpartum period when the risk of relapse is high. Pregnant women who have quit smoking and are interested in saying quit postpartum (N = 300) will be randomly assigned to: 1) a relapse prevention intervention that addresses mood and weight concerns, or 2) a nondirective, supportive condition designed to control for the effects of therapeutic time and attention. We hypothesize that relapse will be less likely at 6 and 12 months postpartum for women in the intervention group than those in the supportive condition. We will also examine the mediators and moderators of treatment response. Results of this investigation will provide information on the efficacy of a cognitive behavioral relapse prevention intervention that incorporates strategies to address mood and weight concerns to prevent smoking relapse and inform future research on the prevention of smoking and other drug use postpartum.