title: Impact of the 5As brief counseling on smoking cessation among pregnant clients of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics in Ohio.
abstract: OBJECTIVE
  We assessed whether smoking cessation improved among pregnant smokers who attended Women, Infants and Children (WIC) Supplemental Nutrition Program clinics trained to implement a brief smoking cessation counseling intervention, the 5As: ask, advise, assess, assist, arrange.
  
  
  METHODS
  In Ohio, staff in 38 WIC clinics were trained to deliver the 5As from 2006 through 2010. Using 2005-2011 Pregnancy Nutrition Surveillance System data, we performed conditional logistic regression, stratified on clinic, to estimate the relationship between women's exposure to the 5As and the odds of self-reported quitting during pregnancy. Reporting bias for quitting was assessed by examining whether differences in infants' birth weight by quit status differed by clinic training status.
  
  
  RESULTS
  Of 71,526 pregnant smokers at WIC enrollment, 23% quit. Odds of quitting were higher among women who attended a clinic after versus before clinic staff was trained (adjusted odds ratio, 1.16; 95% confidence interval, 1.04-1.29). The adjusted mean infant birth weight was, on average, 96 g higher among women who reported quitting (P<0.0001), regardless of clinic training status.
  
  
  CONCLUSIONS
  Training all Ohio WIC clinics to deliver the 5As may promote quitting among pregnant smokers, and thus is an important strategy to improve maternal and child health outcomes.
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: oolaiya@cdc.gov.
authors.forename: Oluwatosin
authors.initials: O
authors.lastname: Olaiya
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; U.S. Public Health Service Commissioned Corps, Atlanta, GA, USA.
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Sharma
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Van T
authors.initials: VT
authors.lastname: Tong
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; U.S. Public Health Service Commissioned Corps, Atlanta, GA, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Dee
authors.affiliation: Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA; Ohio Department of Health, Columbus, OH, USA.
authors.forename: Celia
authors.initials: C
authors.lastname: Quinn
authors.affiliation: Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA; Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Israel T
authors.initials: IT
authors.lastname: Agaku
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; Ohio Department of Health, Columbus, OH, USA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Conrey
authors.affiliation: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Kuiper
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Glen A
authors.initials: GA
authors.lastname: Satten
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D003376:Counseling / Q000379:methods*; D005260:Female; D063105:Food Assistance; D006293:Health Promotion; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D055815:Young Adult
keywords: Counseling; Ohio; Pregnancy; Smoking cessation; WIC