Learning Objectives: Describe the effects of increasing the intensity of cessation treatment in pregnant smokers
Abstract:
Problem/Objective: To assess the efficacy of two protocols in motivating attendance to smoking cessation classes and initiating abstinence from tobacco in pregnant patients attending a community obstetrics clinic.
Methods: Volunteer smokers are randomly assigned to one of two groups. Group 1 (Basic) receives: a) medical advice to quit, b) information on health risks of tobacco use, c) smoking cessation program contact information, and d) encouragement to attend the classes. Group 2 (Enhanced) receives the same treatment as Group 1 plus: e) full-time telephonic smoking cessation information and support, f) detailed cessation workbook, g) assistance in scheduling cessation classes, and h) telephone reminders of their appointments 24 hours prior to the classes. Self-reported number of cigarettes, breath carbon monoxide concentration (CO) and presence of urine cotinine/nicotine are determined monthly.
Results: Average breath CO concentration is 18.8 ppm for Group1 and 12.2 ppm for Group 2. Of the 25 women assigned to Group 1, none have attended smoking cessation classes. Two women in Group 2 (Enhanced) have attended 1 cessation class each. And 1 participant from each group has quit smoking.
Conclusions: In short, neither protocol appears to be especially effective in bringing participants to cessation classes or in motivating smoking cessation. This is a population in which the health risks of smoking are highest, and one in which even moderate success would have a tremendous impact on health and future health care costs. More research is needed, and intensive interventions including pharmacotherapy and reinforcement of abstinence should be considered.
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