title: The contribution of clinic-based interventions to reduce prenatal smoking prevalence among US women.
abstract: OBJECTIVE
  We sought to estimate the effect of universal implementation of a clinic-based, psychosocial smoking cessation intervention for pregnant women.
  
  
  METHODS
  We used data from US birth certificates (2005) and the Pregnancy Risk Assessment Monitoring System (2004) to estimate the number of women smoking at conception. To calculate the number of women eligible to receive the cessation intervention, we used estimates from the literature of the percentage of women who quit spontaneously (23%), entered prenatal care before the third trimester (96.5%), and disclosed smoking to their provider (75%). We used the pooled relative risk (RR) for continued smoking from the 2004 Cochrane Review as our measure of the intervention's effectiveness (RR = 0.94).
  
  
  RESULTS
  We estimated that 944,240 women smoked at conception. Of these, 23.0% quit spontaneously, 6.3% quit with usual care, and an additional 3.3% quit because of the intervention, leaving 67.4% smoking throughout pregnancy. The calculated smoking prevalence in late pregnancy decreased from 16.4% to 15.6% because of the intervention.
  
  
  CONCLUSIONS
  Universal implementation of a best-practice, clinic-based intervention would increase the total number of quitters but would not substantially reduce smoking prevalence among pregnant women.
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. skim1@cdc.gov
authors.forename: Shin Y
authors.initials: SY
authors.lastname: Kim
authors.forename: Lucinda J
authors.initials: LJ
authors.lastname: England
authors.forename: Juliette S
authors.initials: JS
authors.lastname: Kendrick
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Dietz
authors.forename: William M
authors.initials: WM
authors.lastname: Callaghan
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006293:Health Promotion / Q000706:statistics & numerical data*; D006801:Humans; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D008430:Maternal-Child Health Centers / Q000706:statistics & numerical data*; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000517:prevention & control; D011295:Prenatal Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012306:Risk; D012907:Smoking / Q000453:epidemiology*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult