title: Randomized trial of a "stage-of-change" oriented smoking cessation intervention in infertile and pregnant women.
abstract: OBJECTIVE
  To assess a "stage-of-change" oriented smoking cessation intervention for infertile and pregnant women, compared with standard of care.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Three university teaching hospitals in Hamilton, Ontario, Canada.
  
  
  METHODS
  Infertile women at their first visit to a tertiary referral infertility clinic (n = 94) and new patients seeking pre-natal care (n = 110) who had smoked >/= 3 cigarettes in the past six months.
  
  
  METHODS
  A three to five minute scripted intervention and booklet specific to the woman's "stage-of-change" in the smoking continuum, versus standard of care. Exhaled carbon-monoxide (CO) monitoring was used to validate exposure in both groups.
  
  
  METHODS
  Delta "stage-of-change" and rate of maintained cessation at 12 months post follow-up.
  
  
  RESULTS
  Intervention and control were similarly effective for infertile women: the rate of maintained cessation rose significantly from 4% to 24% over twelve months, with a mean delta "stage-of-change" 0.28. In prenatal women, neither approach was effective. Maintained cessation did not significantly change from 0 to 12 months (19% to 18%). Mean delta "stage-of-change" declined by -0.62.
  
  
  CONCLUSIONS
  For infertile women, basic information describing the impact of smoking on fertility, along with exhaled CO monitoring and a more intensive intervention were both highly effective. In pregnant women neither approach was beneficial, with some evidence of post-partum relapse.
authors.affiliation: Departments of Obstetrics and Gynecology and Family Medicine, McMaster University, Hamilton, Ontario, Canada. hughese@fhs.csu.mcmaster.ca
authors.forename: E G
authors.initials: EG
authors.lastname: Hughes
authors.forename: D A
authors.initials: DA
authors.lastname: Lamont
authors.forename: M L
authors.initials: ML
authors.lastname: Beecroft
authors.forename: D M
authors.initials: DM
authors.lastname: Wilson
authors.forename: B G
authors.initials: BG
authors.lastname: Brennan
authors.forename: S C
authors.initials: SC
authors.lastname: Rice
mesh_terms: D000328:Adult; D001944:Breath Tests; D002248:Carbon Monoxide / Q000032:analysis; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000523:psychology*; D011247:Pregnancy / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D002248:Carbon Monoxide