EVALUATION OF ANTENATAL SMOKING CESSATION PROGRAMS FOR PREGNANT-WOMEN

Smoking during pregnancy has been linked to health problems, including the risk of low birthweight, preterm labour, spontaneous abortion and perinatal death. Two trials to investigate the efficacy of self-help materials were undertaken. During the first trial, a self-help booklet developed overseas was evaluated through a randomised controlled desi gn to determine the effects of the booklet:alone, compared with the bo oklet with midwife counselling for the women. We recruited 217 women i nto the study and followed them up at 20 weeks' gestation to ascertain smoking cessation and to measure process variables. Smoking cessation rates were lower than expected, and process measures indicated that m aterials were not being used. A second trial was commenced after a com prehensive review of the materials with focus groups of pregnant women and one-to-one interviews of nurses and doctors. Trial 2 was based ne w materials, and used a magazine-style (smoking cessation) booklet des igned by the focus groups. A total of 119 women were randomly allocate d into the new-materials group or a usual-care group. The materials we re well received, re levant and pertinent, and were used by the women. Smoking cessation rates at 20 weeks' gestation were biochemically val idated and indicated that 9 per cent in the intervention group and non e in the usual-care group had stopped smoking. The use of overseas pro grams needs to be approached with caution.