Preventing postpartum smoking relapse among diverse low-income women: a randomized clinical trial.
BACKGROUND
Postpartum relapse rates are high among women who spontaneously quit smoking during pregnancy. This randomized clinical trial tested a Motivation and Problem-Solving (MAPS) treatment for reducing postpartum relapse among diverse low-income women who quit smoking during pregnancy (N = 251; 32% Black, 30% Latino, and 36% White; 55% <$30,000/year household income).


METHODS
Pregnant women were randomly assigned to MAPS/MAPS+ or Usual Care (UC). Continuation ratio logit models were used to examine differences in biochemically confirmed continuous abstinence at Weeks 8 and 26 postpartum by treatment group and moderators of the treatment effect. Analyses controlled for age, race/ethnicity, partner status, education, smoking rate, and the number of smokers in the participant's environment.


RESULTS
MAPS/MAPS+ was more efficacious than UC in the prevention of postpartum relapse (p = .05). An interaction between treatment and the number of cigarettes smoked per day before quitting approached significance (p = .09), suggesting that the MAPS/MAPS+ treatment effect was stronger among women who smoked more cigarettes per day.


CONCLUSIONS
MAPS, a holistic and dynamic approach to changing behavior using a combined motivational enhancement and social cognitive approach, is a promising intervention for postpartum smoking relapse prevention among low-income women, which may have particular relevance for women with higher prequit smoking rates.
Department of Health Disparities Research, University of Texas M.D. Anderson Cancer Center, Unit 1440, P.O. Box 301402, Houston, TX 77230, USA. lrreitze@mdanderson.org
Lorraine R
LR
Reitzel
Jennifer Irvin
JI
Vidrine
Michael S
MS
Businelle
Darla E
DE
Kendzor
Tracy J
TJ
Costello
Yisheng
Y
Li
Patricia
P
Daza
Patricia Dolan
PD
Mullen
Mary M
MM
Velasquez
Paul M
PM
Cinciripini
Ludmila
L
Cofta-Woerpel
David W
DW
Wetter
D000328:Adult; D005260:Female; D006801:Humans; D007182:Income; D049590:Postpartum Period; D011247:Pregnancy; D055502:Secondary Prevention; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D055815:Young Adult