Elsevier

Preventive Medicine

Volume 27, Issue 3, May 1998, Pages 422-430
Preventive Medicine

Regular Article
Reducing Smoking during Pregnancy and Postpartum: Physician's Advice Supported by Individual Counseling,☆☆

https://doi.org/10.1006/pmed.1998.0287Get rights and content

Abstract

Background. Physicians' advice to help pregnant women quit smoking during prenatal care has had mixed results. Training and prompting physicians to provide consistent advice and referral to on-site support might improve cessation rates.

Methods. Pregnant women who smoked were randomly assigned to receive structured advice from their physician and referral to individual behavior change counseling during prenatal care or to receive brief advice to stop smoking and a quit smoking booklet at their first visit. Smoking status was measured by self-report, exhaled carbon monoxide, and urinary cotinine.

Results. Compared with usual care, greater proportions of intervention group women reported not smoking at the 36th-week visit (14% vs 10%) and at 1 year postpartum (18% vs 11%), but these differences were not significant. However, significantly greater proportions of intervention group women reported either not smoking or reducing their cigarette consumption by 50% or more at their second visit (43% vs 29%,P= 0.02), at their 36th-week visit (40% vs 25%,P< 0.01), and at 1 year postpartum (26% vs 14%,P= 0.02).

Conclusions. Physician training on how to gain a pregnant smoker's commitment to change her smoking behavior, an office prompt system, and individualized smoking behavior change counseling show promise in reducing smoking during pregnancy and postpartum, but practical methods to assist pregnant smokers between regular prenatal visits, as they attempt to quit, need to be developed.

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    Support for this study was provided by the National Institutes of Health, Grants HL29957 and CA22435. This study was initiated and analyzed solely by the investigators.

    ☆☆

    We are most grateful to the late Sandra S. Lepage, M.S.N., for all she did to help intervention group participants change their smoking behavior. We also thank Jane E. Crammond, R.N., for enrolling women into this study and conducting the interviews.

    2

    To whom correspondence and reprint requests should be addressed at 1 South Prospect Street, Burlington, VT 05401. Fax: (802) 656-8826. E-mail:[email protected].

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