Evaluation of a motivational smoking cessation intervention for women in public health clinics

Background. A multicomponent motivational smoking cessation intervention wa s evaluated in 33 prenatal, family planning, and pediatric services in 12 p ublic health clinics. Clinic-based intervention components were implemented by clinic personnel as part of routine medical visits. Methods. The evaluation design included pre- and postintervention measureme nts of multiple study outcomes in a baseline (all clinics prior to the star t of the intervention) and an experimental period (matched-pair random assi gnment of clinics to intervention or control conditions). Subjects were 683 (baseline) and 1,064 (experimental) smokers with measurements of smoking o utcomes at both times, Mixed-effects regressions analyzed individual outcom es clustered within clinics and services. Results. Control and intervention clinics had similar outcomes in the basel ine period. In the experiment, outcomes improved in the intervention but no t in the control clinics. Compared to controls, smokers exposed to the inte rvention were more likely to have quit (14.5 versus 7.7%) or take actions t oward quitting and had higher mean action, stage of readiness, and motivati on to quit scores. These positive effects persisted when clustering within clinics and services was controlled. Conclusions. This intervention, implemented by clinic personnel as part of routine medical visits, was effective under these natural conditions across different types of clinic service, (C) 1999 American Health Foundation and Academic Press.