Integrating smoking cessation into routine public prenatal care: the Smoking Cessation in Pregnancy project.
OBJECTIVE
In 1986, the state health departments of Colorado, Maryland, and Missouri conducted a federally-funded demonstration project to increase smoking cessation among pregnant women receiving prenatal care and services from the Women, Infants, and Children (WIC) program in public clinics.


METHODS
Low-intensity interventions were designed to be integrated into routine prenatal care. Clinics were randomly assigned to intervention or control status; pregnant smokers filled out questionnaires and gave urine specimens at enrollment, in the eighth month of pregnancy, and postpartum. Urine cotinine concentrations were determined at CDC by enzyme-linked immunosorbent assay and were used to verify self-reported smoking status.


RESULTS
At the eighth month of pregnancy, self-reported quitting was higher for intervention clinics than control clinics in all three states. However, the cotinine-verified quit rates were not significantly different.


CONCLUSIONS
Biochemical verification of self-reported quitting is essential to the evaluation of smoking cessation interventions. Achieving changes in smoking behavior in pregnant women with low-intensity interventions is difficult.
Centers for Disease Control and Prevention, Atlanta, Ga 30341-3724.
J S
JS
Kendrick
S C
SC
Zahniser
N
N
Miller
N
N
Salas
J
J
Stine
P M
PM
Gargiullo
R L
RL
Floyd
F W
FW
Spierto
M
M
Sexton
R W
RW
Metzger
D000328:Adult; D003367:Cotinine / Q000652:urine; D004522:Educational Status; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008393:Marriage; D010298:Parity; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation; D014028:Tobacco Smoke Pollution; D014481:United States / Q000453:epidemiology
D014028:Tobacco Smoke Pollution; D003367:Cotinine