A randomized controlled trial of a smoking cessation intervention for pregnant adolescents.
BACKGROUND
The smoking prevalence rate among pregnant adolescents has been estimated at 59-62%, and 60-80% of these adolescents continue to smoke throughout their pregnancies.


OBJECTIVE
The aim of this study was to evaluate the short- and long-term effects of smoking cessation strategies tailored to the pregnant adolescent to attain and maintain abstinence. The specific aim was to examine differences in short- and long-term smoking behaviors among three groups: Teen FreshStart (TFS), Teen FreshStart Plus Buddy (TFS-B), and Usual Care (UC) control.


METHODS
In this randomized controlled intervention study, a 3-group (TFS, TFS-B, and UC) by 3-occasion (baseline, 8 weeks postrandomization, and 1-year following study entry) design was used. The study included 142 pregnant adolescents who were aged 14 to 19 years. Both self-reported smoking status collected on the Smoking History Questionnaire and saliva cotinine levels were used to identify smoking behaviors.


RESULTS
There were no significant differences among the three treatment groups at baseline in terms of the racial distribution, age, gestational age, age of menses initiation, number in family household, number of family members who smoked, or tobacco use. A significant difference between the UC group and the TFS-B group (p = .010) was seen in smoking behaviors measured 8 weeks following treatment initiation. At 1 year following study entry, however, there were no differences between the groups in smoking behaviors.


CONCLUSIONS
The TFS-B intervention was more effective in attaining short-term smoking cessation in the pregnant adolescent than TFS or UC. Findings suggest that the peer-enhanced programming had a limited effect but could not sustain the participant beyond postpartum (1 year following study entry). Future studies should include relapse prevention to sustain smoking abstinence into the postpartum period.
Albrecht
Susan A
SA
School of Nursing, University of Pittsburgh, PA 15261, USA. saa01@pitt.edu
Caruthers
Donna
D
Patrick
Thelma
T
Reynolds
Maureen
M
Salamie
Denise
D
Higgins
Linda W
LW
Braxter
Betty
B
Kim
Yookyung
Y
Mlynarchek
Sara
S
D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy; D003367:Cotinine / Q000032:analysis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D010379:Peer Group; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D012463:Saliva / Q000737:chemistry; D016540:Smoking Cessation / Q000379:methods*; D012944:Social Support; D014481:United States
D003367:Cotinine