REDUCING MATERNAL SMOKING AND RELAPSE - LONG-TERM EVALUATION OF A PEDIATRIC INTERVENTION

Background. Pediatric well-care visits provide a clinical opportunity to counsel new mothers about their smoking and the deleterious effects of environmental tobacco smoke (ETS) on infant health. Methods. Forty -nine Oregon pediatric offices enrolled 2,901 women who were currently smoking or had quit for pregnancy, using a brief survey at the newbor n's first office visit. Randomly assigned offices provided advice and materials to mothers at each well-care visit during the first 6 months postpartum to promote quitting or relapse prevention. Results. The in tervention reduced smoking (5.9% vs 2.7%) and relapse (55% vs 45%) at 6-month follow-up, but logistic regression analysis at 12 months revea led no significant treatment effect. The intervention had a positive e ffect on secondary outcome variables, such as readiness to quit and at titude toward and knowledge of ETS. Multiple logistic regression analy sis indicated that husband/partner smoking was the strongest predictor of maternal quitting or relapse.Conclusions. A pediatric office-based intervention can significantly affect smoking and relapse prevention for mothers of newborns, but the effect decreases with time. Consisten t prompting of the provider to give brief advice and materials at well -care visits could provide a low-cost intervention to reduce infant ET S exposure. (C) 1997 Academic Press.