The use of significant reduction rates to evaluate health education methods for pregnant smokers: a new harm reduction behavioral indicator?
This article evaluates the evidence to support the use of biochemical measurement of significant reduction (SR) rates among pregnant smokers as a new behavioral indicator of "harm reduction" (HR). The results of four studies--three randomized patient education clinical trials of pregnant smokers (Trials I, II, and III) and an epidemiological study (Study IV)--are presented. Among Trial I, II, and III cohorts of pregnant smokers, control group SR rates of 7% (I), 9% (II), and 20% (III) were increased among experimental groups to 17% (I), 18% (II), and 32% (III) by the same patient education methods. Analyses of infant birthweight data in Study IV found that a patient SR rate representing a 50% or more decrease between a baseline and follow-up test was associated with an increase in adjusted birthweight of 92 grams.
Windsor
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Department of Human Studies, University of Alabama at Birmingham 35233-7333, USA. rwindsor@uab.edu
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Boyd
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Hartmann
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D000328:Adult; D000407:Alabama; D015415:Biomarkers; D001724:Birth Weight; D002248:Carbon Monoxide / Q000378:metabolism; D003362:Cost-Benefit Analysis; D003367:Cotinine / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D005260:Female; D006266:Health Education / Q000191:economics / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008370:Manuals as Topic; D008484:Medicaid / Q000706:statistics & numerical data; D009657:North Carolina; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D000074606:Smoking Prevention; D013861:Thiocyanates / Q000378:metabolism; D014481:United States
D015415:Biomarkers; D013861:Thiocyanates; D002248:Carbon Monoxide; D003367:Cotinine