STATEWIDE ASSESSMENT OF A BEHAVIORAL INTERVENTION TO REDUCE CIGARETTE-SMOKING BY PREGNANT-WOMEN

OBJECTIVE: Smoking in pregnancy is the foremost cause of preventable p erinatal mortality. We have demonstrated that a behavioral interventio n can alter smoking in pregnant women. We tested the utility of this i ntervention at multiple sites in varied settings across a suburban-rur al state. STUDY DESIGN: We performed a prospective cohort study at 10 prenatal care sites across North Carolina. Carbon monoxide manometry w as used to verify cessation; self-report confirmed reduction. Each sit e enrolled smokers for 1 year. Four outcome predictor variables were s tudied: clinic volume, prevalence of smoking, physician versus nonphys ician interveners, and public versus private clinics. RESULTS: Smoking prevalence varied from 4% to 85%. Biologically confirmed quit rates r anged from 0% to 45%. The prevalence of smoking within a clinic's popu lation was able to explain differences in reduction (p < 0.01) of smok ing between sites. CONCLUSION: We have demonstrated the effectiveness of an intervention to alter smoking behavior in pregnancy. It appears that this technique has the greatest utility in clinics with a high pr evalence of smoking.