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.
Reitzel
Lorraine R
LR
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
Vidrine
Jennifer Irvin
JI
Businelle
Michael S
MS
Kendzor
Darla E
DE
Costello
Tracy J
TJ
Li
Yisheng
Y
Daza
Patricia
P
Mullen
Patricia Dolan
PD
Velasquez
Mary M
MM
Cinciripini
Paul M
PM
Cofta-Woerpel
Ludmila
L
Wetter
David W
DW
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