Addressing Postpartum Mood and Weight Concerns to Sustain Smoking Cessation

说明(申请人提供)：大多数在怀孕期间戒烟的妇女会在产后第一年复发，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，暴露在烟草烟雾中与婴儿猝死综合症、耳朵感染、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增加产后持续戒烟率。然而，我们的研究证明，情绪和体重担忧与产后吸烟复发有关，试点数据支持在产后阶段解决情绪和体重担忧的策略的可接受性。因此，这项申请提出了一项新的认知行为产后复发预防计划的随机对照试验，该计划解决了产后复发风险高的产后妇女的情绪和体重问题。已经戒烟并有兴趣在产后说戒烟的孕妇(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)非指导性支持性条件，旨在控制治疗时间和注意力的影响。我们假设，干预组的妇女在产后6个月和12个月时复发的可能性比支持性条件下的妇女低。我们还将检查治疗反应的调解人和主持人。这项调查的结果将提供关于认知行为复发预防干预的有效性的信息，该干预包括解决情绪和体重问题的策略，以防止吸烟复发，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.