title: Postpartum smoking relapse and secondhand smoke.
abstract: OBJECTIVE
  There has been an abundance of research evaluating prenatal and postnatal smoking abstinence programs. However, few researchers have tested postpartum relapse interventions that address secondhand smoke (SHS) exposure. Pregnant women exposed to SHS are more likely to relapse. This article explores the similarities and differences among postpartum interventions that incorporate SHS education. Generating knowledge about the components of postpartum relapse prevention interventions that do and do not achieve prolongation of abstinence is integral to the development of effective SHS interventions that help women achieve lifelong abstinence.
  
  
  METHODS
  We used a methodological review of 11 randomized, controlled trials testing the efficacy of relapse prevention interventions that address SHS exposure. We compared intervention strength, biomarker validation of home smoking and SHS, as well as abstinence and relapse rates. We examined three predictors of postpartum relapse: (1) partner smoking in the home, (2) adoption of home smoking restrictions, and (3) motivation/confidence to remain abstinent.
  
  
  RESULTS
  Findings revealed a need for more comprehensive SHS interventions and a clear delineation of abstinence/relapse terminology. Biomarker validation of home smoking and SHS was primarily measured by self-report, passive nicotine monitors, and hair nicotine levels. Furthermore, studies using nurse- and pediatrician-led interventions resulted in the lowest relapse rates.
  
  
  CONCLUSIONS
  A comprehensive intervention that specifically prioritizes parental education on the health effects of SHS on the family, empowerment of the mother and family members to remain abstinent and adopt a smoke-free home smoking policy, and partner influence on smoking could result in a significant reduction in postpartum relapse rates.
authors.affiliation: University of Kentucky College of Nursing, Lexington, KY 40536-0232, USA. Kristin.Ashford@uky.edu
authors.forename: Kristin B
authors.initials: KB
authors.lastname: Ashford
authors.forename: Ellen
authors.initials: E
authors.lastname: Hahn
authors.forename: Lynne
authors.initials: L
authors.lastname: Hall
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Rayens
authors.forename: Melody
authors.initials: M
authors.lastname: Noland
mesh_terms: D005260:Female; D006801:Humans; D010353:Patient Education as Topic; D049590:Postpartum Period; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D000074606:Smoking Prevention; D014028:Tobacco Smoke Pollution; D014481:United States
chemical_list: D014028:Tobacco Smoke Pollution