Statewide assessment of a behavioral intervention to reduce cigarette smoking by pregnant women.
OBJECTIVE
Smoking in pregnancy is the foremost cause of preventable perinatal mortality. We have demonstrated that a behavioral intervention can alter smoking in pregnant women. We tested the utility of this intervention at multiple sites in varied settings across a suburban-rural state.


METHODS
We performed a prospective cohort study at 10 prenatal care sites across North Carolina. Carbon monoxide manometry was used to verify cessation; self-report confirmed reduction. Each site enrolled smokers for 1 year. Four outcome predictor variables were studied: clinic volume, prevalence of smoking, physician versus nonphysician intervenors, and public versus private clinics.


RESULTS
Smoking prevalence varied from 4% to 85%. Biologically confirmed quit rates ranged from 0% to 45%. The prevalence of smoking within a clinic's population was able to explain differences in reduction (p < 0.01) of smoking between sites.


CONCLUSIONS
We have demonstrated the effectiveness of an intervention to alter smoking behavior in pregnancy. It appears that this technique has the greatest utility in clinics with a high prevalence of smoking.
Wright
L N
LN
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, USA.
Pahel-Short
L
L
Hartmann
K
K
Kuller
J A
JA
Thorp
J M
JM
D001521:Behavior Therapy; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008365:Manometry; D009657:North Carolina; D011247:Pregnancy; D011295:Prenatal Care; D011446:Prospective Studies; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome