title: Pediatric office-based smoking intervention: impact on maternal smoking and relapse.
abstract: OBJECTIVE
  To determine the impact of a brief smoking intervention delivered by pediatricians in the context of usual well baby office visits on postnatal maternal smoking and relapse.
  
  
  METHODS
  Forty-nine private pediatric practices including 128 practitioners.
  
  
  METHODS
  Randomization of pediatric practices into minimal and extended intervention sites with all enrolled mothers of newborns within a practice receiving the same level of intervention.
  
  
  METHODS
  Smoking mothers in minimal condition received a hospital packet containing written information about passive smoking and a letter advising them to quit. Those in extended condition received the hospital packet plus oral and written advice at usual well baby visits: 2 weeks, 2, 4, and 6 months.
  
  
  METHODS
  Smoking and relapse rates at 6 months postpartum, demographics associated with smoking status, attitudes, and knowledge in regard to passive smoking, and recall surveys of mothers in regard to receiving advice or written materials.
  
  
  RESULTS
  Two-thousand nine-hundred-one mothers of newborns were enrolled in the study. Those in the extended condition had higher quit rates (5.9% vs 2.7%, P < .01) and lower relapse rates (45% vs 55%, P < .01) than those in the minimal condition. Mothers' educational status and the presence of a smoking partner in the home were the major demographic variables associated with smoking status at enrollment and at follow-up. Compared with smokers in the minimal condition, those in extended at 6 months postpartum had significantly better attitudes and knowledge regarding passive smoking and allowed less smoking in the home. Mothers attending extended practices reported much higher rates of receiving oral advice and written materials than those in the minimal condition.
  
  
  CONCLUSIONS
  A brief program can lead to major increases in the willingness of pediatricians to deliver smoking advice. A 1- to 2-minute intervention delivered in the context of usual well baby care can have a positive impact on maternal smoking and especially upon relapse prevention. A recent smoking history should be obtained from all mothers of newborns so that interventions can be aimed at both cessation and relapse prevention.
authors.affiliation: Department of Pediatrics, Oregon Health Sciences University, Portland 97201, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Wall
authors.forename: H H
authors.initials: HH
authors.lastname: Severson
authors.forename: J A
authors.initials: JA
authors.lastname: Andrews
authors.forename: E
authors.initials: E
authors.lastname: Lichtenstein
authors.forename: L
authors.initials: L
authors.lastname: Zoref
mesh_terms: D005260:Female; D006293:Health Promotion; D006801:Humans; D008425:Maternal Behavior; D010372:Pediatrics; D010819:Physician's Role; D016540:Smoking Cessation / Q000379:methods*; D012959:Socioeconomic Factors