Individualized smoking cessation counseling during prenatal and early postnatal care.
OBJECTIVE
We examined the efficacy of individualized smoking cessation counseling added to obstetricians' and nurse-midwives' advice.


METHODS
In a mixed private and publicly supported prenatal clinic 600 pregnant women who smoked were randomly assigned to receive the usual advice from their obstetrician or nurse-midwife or the usual advice plus individualized smoking cessation counseling. Smoking status was measured by self-report and urinary cotinine/creatinine ratios at 36 weeks and by self-report during long-term postpartum follow-up.


RESULTS
Quitting rates during pregnancy were not increased by adding individualized smoking cessation counseling to usual care. At the long-term follow-up, reported quitting rates were significantly greater among intervention group women cared for in the publicly supported clinic than among those receiving the usual care, 14.5% versus 2.5%, p < 0.01.


CONCLUSIONS
Although adding individual smoking cessation counseling did not increase quitting rates during pregnancy, it should be considered for women in public maternity clinics because of its potential long-term effectiveness.
Office of Health Promotion Research, University of Vermont, Burlington.
R H
RH
Secker-Walker
L J
LJ
Solomon
B S
BS
Flynn
J M
JM
Skelly
S S
SS
Lepage
G D
GD
Goodwin
P B
PB
Mead
D000328:Adult; D001294:Attitude to Health; D001724:Birth Weight; D003367:Cotinine / Q000652:urine; D003376:Counseling; D003404:Creatinine / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel; D006801:Humans; D008137:Longitudinal Studies; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care; D012044:Regression Analysis; D012907:Smoking; D016540:Smoking Cessation
D003404:Creatinine; D003367:Cotinine