title: Staying smoke free: an intervention to prevent postpartum relapse.
abstract: This pilot study evaluated the effectiveness of a nurse-delivered home-visiting program during the postpartum period that included a low-intensity smoking relapse-prevention intervention. A prospective two-group design was used. Participants were women who had quit smoking during their pregnancy. They were invited to participate during postpartum hospitalization on a university hospital postpartum ward. A brief intervention during postpartum hospitalization, a home visit, and two follow-up phone calls over a 1- to 2-month period were compared with a routine home visit without any prescribed focus on tobacco use. The main outcome was biochemically verified smoking abstinence at 3 and 6 months postenrollment. Abstinence was defined as a salivary cotinine level of 14 ng/ml or less. At 3 months postenrollment, 26.4% of the intervention group were classified as abstinent, compared with 12.4% of the comparison group (OR = 2.4, 95% CI = 1.16-4.98). At 6 months, the proportion of the intervention group categorized as abstinent was 21.5%, compared with 10.2% of comparison group participants (OR = 2.5, 95% CI = 1.13-5.71). Greater than three times as many in the intervention group remained abstinent at both times (18.2%), compared with the comparison group (5.2%; OR = 2.4, 95% CI = 1.16-4.93). The effectiveness of this brief, low-cost, and potentially replicable intervention in improving the rate of persistent postpartum smoke-free status for women who quit smoking during pregnancy is encouraging. A randomized trial of the approach is warranted.
authors.affiliation: Community Pediatrics, Department of Pediatrics, University of Hawaii John Burns College of Medicine, Honolulu, HI 96820, USA. gina.french@kapiolani.org
authors.forename: Gina M
authors.initials: GM
authors.lastname: French
authors.forename: Judith A
authors.initials: JA
authors.lastname: Groner
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Wewers
authors.forename: Karen
authors.initials: K
authors.lastname: Ahijevych
mesh_terms: D000293:Adolescent; D000328:Adult; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006254:Hawaii; D006699:Home Care Services; D006801:Humans; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D016017:Odds Ratio; D010865:Pilot Projects; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D055502:Secondary Prevention; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D000074606:Smoking Prevention; D016896:Treatment Outcome