Learning Objectives: explain the value of using different recruitment strategies to enroll pregnant smokers into cessation services.
Abstract: Since even low levels of maternal smoking can adversely affect the fetus it is important to help pregnant smokers quit. The California Smokers’ Helpline (CSH) provides a specialized telephone counseling protocol for pregnant women. Some pregnant smokers take the initiative to call CSH and are identified at screening. CSH also collaborates with healthcare systems to recruit pregnant smokers into treatment directly.
From 3/99 to 3/02, 3,347 pregnant smokers received service from CSH; 2,257 called on their own (reactive referrals—RR) and 1,090 came through the healthcare systems (proactive referrals—PP).
PR and RR were similar on confidence and age, but PR more often reported receiving advice to quit from healthcare providers (75% vs. 70%). RR were less educated and more ethnically diverse than PR, indicating broad appeal of telephone cessation services. PR smoked fewer cigarettes per day (7.5) than RR (12.2) and were not as often ready to quit within a week (66% vs. 87%). Over two thirds of PR had a complete ban on smoking in the home compared to only 47% of RR.
Telephone counseling is an appealing and promising intervention for pregnant smokers. Women who call for services benefit from help with planning and relapse prevention. Referrals through the healthcare system include pregnant women who are lighter smokers. It is possible that these women have taken intermediate measures (e.g. decreasing consumption and secondhand exposure) and are feeling less pressure to quit. However, they are willing to receive services and might especially benefit from counseling that focuses on motivation.
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