Randomized trial of a "stage-of-change" oriented smoking cessation intervention in infertile and pregnant women

Objective: To assess a "stage-of-change" oriented smoking cessation interve ntion for infertile and pregnant women, compared with standard of care. Design: Randomized controlled trial. Setting: Three university teaching hospitals in Hamilton, Ontario, Canada. Patient(s): Infertile women at their first visit to a tertiary referral inf ertility clinic (n = 94) and new patients seeking pre-natal care (n = 110) who had smoked greater than or equal to 3 cigarettes in the past six months . Intervention(s): A three to five minute scripted intervention and booklet s pecific to the woman's "stage-of-change" in the smoking continuum, versus s tandard of care. Exhaled carbon-monoxide (CO) monitoring was used to valida te exposure in both groups. Main Outcome Measure(s): Delta "stage-of-change" and rate of maintained ces sation at 12 months post follow-up. Result(s): Intervention and control were similarly effective for infertile women. the rate of maintained cessation rose significantly from 4% to 24% o ver twelve months, with a mean delta "stage-of-change" 0.28. In prenatal wo men, neither approach was effective. Maintained cessation did not significa ntly change fr om 0 to 12 months (19% to 18%). Mean delta ''stage-of-change " declined by -0.62. Conclusion(s): Fur infertile women, basic information describing the impact of smoking on fertility, along with exhaled CO monitoring and a more inten sive intervention were both highly effective. In pregnant women neither app roach was beneficial, with some evidence of post-partum relapse. (Fertil St eril(R) 2000;74:498 -503. (C) 2000 by American Society for Reproductive Med icine.).