title: Statewide assessment of a behavioral intervention to reduce cigarette smoking by pregnant women.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, USA.
authors.forename: L N
authors.initials: LN
authors.lastname: Wright
authors.forename: L
authors.initials: L
authors.lastname: Pahel-Short
authors.forename: K
authors.initials: K
authors.lastname: Hartmann
authors.forename: J A
authors.initials: JA
authors.lastname: Kuller
authors.forename: J M
authors.initials: JM
authors.lastname: Thorp
mesh_terms: 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