title: Efficacy and cost-effectiveness of a clinic-based counseling intervention tested in an ethnically diverse sample of pregnant smokers.
abstract: OBJECTIVE
  Rates of cigarette smoking are higher among women who receive obstetric care through publicly funded prenatal clinics. This study compared smoking outcomes for pregnant women (n=105) who were randomized to receive either usual care (standard cessation advice from the health care provider) or an intervention conducted in the prenatal clinic consisting of 1.5 h of counseling plus telephone follow-up delivered by a masters prepared mental health counselor.
  
  
  METHODS
  Subjects were 105 low income, predominantly Hispanic, pregnant patients in an urban prenatal clinic. Smoking outcomes were assessed at end of pregnancy and 6 months post-partum.
  
  
  RESULTS
  At follow-up, 28.3% and 9.4% of participants in the experimental intervention and 9.6% and 3.8% of patients in usual care were abstinent at end of pregnancy (p=.015) and 6 months post-partum, respectively (p=.251). Cost of the intervention was $56 per patient and cost to produce a non-smoker at end of pregnancy was $299.
  
  
  CONCLUSIONS
  This model for intervention was cost-effective and was associated with significantly lower smoking rates at end of pregnancy.
  
  
  CONCLUSIONS
  If these findings are replicated, prenatal clinics could offer the option for intensive smoking cessation treatment by training mental health counselors to deliver one extended smoking cessation counseling session.
authors.affiliation: Hartford Hospital, Department of Medicine, Hartford, CT 06102-5037, USA. edornel@harthosp.org
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Dornelas
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Magnavita
authors.forename: Tryfon
authors.initials: T
authors.lastname: Beazoglou
authors.forename: Edward H
authors.initials: EH
authors.lastname: Fischer
authors.forename: Cheryl
authors.initials: C
authors.lastname: Oncken
authors.forename: Harry
authors.initials: H
authors.lastname: Lando
authors.forename: John
authors.initials: J
authors.lastname: Greene
authors.forename: Jeremy
authors.initials: J
authors.lastname: Barbagallo
authors.forename: Roxanne
authors.initials: R
authors.lastname: Stepnowski
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gregonis
mesh_terms: D001741:Black or African American / Q000193:education / Q000208:ethnology; D000359:Aftercare / Q000458:organization & administration / Q000523:psychology; D000553:Ambulatory Care / Q000458:organization & administration / Q000523:psychology; D001294:Attitude to Health / Q000208:ethnology; D003237:Connecticut / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000458:organization & administration*; D018864:Cultural Diversity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000193:education / Q000208:ethnology; D006801:Humans; D010353:Patient Education as Topic / Q000458:organization & administration; D011181:Postnatal Care / Q000458:organization & administration / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology / Q000517:prevention & control*; D011295:Prenatal Care / Q000458:organization & administration*; D015995:Prevalence; D015397:Program Evaluation; D011614:Psychotherapy, Brief / Q000458:organization & administration*; D012907:Smoking / Q000208:ethnology; D016540:Smoking Cessation / Q000208:ethnology / Q000379:methods; D000074606:Smoking Prevention; D013689:Telephone; D016896:Treatment Outcome; D044465:White People / Q000193:education / Q000208:ethnology