Document Detail


Smoking relapse prevention during pregnancy. A trial of coordinated advice from physicians and individual counseling.
MedLine Citation:
PMID:  9651635     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Our objective was to examine the efficacy of physicians' advice and referral to individual counseling in preventing relapse to smoking among women who were smokers early in pregnancy, but quit prior to their first prenatal visit. DESIGN: A randomized controlled trial of prompted physician's advice and individual relapse prevention counseling during pregnancy compared to usual physician advice. Smoking status was assessed by self-report, exhaled carbon monoxide, and urinary cotinine during pregnancy and by self-report 1 year postpartum. RESULTS: There were no significant differences in relapse rates between the intervention and usual-care groups during pregnancy, nor at 1 year postpartum. Relapse rates were 23% in both groups at the 36-week visit, and 32% and 22%, respectively, 1 year postpartum. Younger age, higher motivation to resume smoking, and higher levels of exhaled carbon monoxide at the first prenatal visit were predictive of relapse to smoking during pregnancy. With the conservative assumption that all those lost to follow-up relapsed, the combined 1-year postpartum relapse rate, 51%, was 17 percentage points lower than we observed in an earlier relapse prevention trial, and 15 percentage points lower than that observed nationally a decade earlier. CONCLUSION: Prompting physicians to provide supportive advice combined with referral to individual relapse prevention counseling did not reduce smoking relapse rates during pregnancy, or postpartum. However, the level of attention paid to smoking by physicians in both intervention and usual-care groups during pregnancy may have contributed to the relatively low relapse rates seen 1-year postpartum.
Authors:
R H Secker-Walker; L J Solomon; B S Flynn; J M Skelly; P B Mead
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of preventive medicine     Volume:  15     ISSN:  0749-3797     ISO Abbreviation:  Am J Prev Med     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-09-30     Completed Date:  1998-09-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8704773     Medline TA:  Am J Prev Med     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  25-31     Citation Subset:  IM    
Affiliation:
Office of Health Promotion Research, University of Vermont, Burlington, Vermont 05401-3444, USA. rseckerw@zoo.uvm.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Chi-Square Distribution
Confidence Intervals
Female
Follow-Up Studies
Humans
Logistic Models
Odds Ratio
Patient Education as Topic / methods,  standards*
Pregnancy
Pregnancy Complications / prevention & control*
Prenatal Care / methods,  standards
Program Evaluation
Prospective Studies
Recurrence / prevention & control
Referral and Consultation / standards
Smoking / prevention & control*
Smoking Cessation / methods
Treatment Outcome
Grant Support
ID/Acronym/Agency:
CA22435/CA/NCI NIH HHS; HL29957/HL/NHLBI NIH HHS

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