Smoking during pregnancy increases women's risk of complications of pregnancy and numerous birth outcomes. Two-thirds of women smokers continue to smoke during pregnancy, with particularly high rates of smoking among low income and less educated women. For the majority of women, pregnancy occurs in the context of an intimate relationship that pregnant women report as their primary source of support. However, naturally occurring partner support may not be enough to assist pregnant smokers with cessation, particularly when the partner is a smoker. The proposed study is a five year randomized trial to evaluate the incremental improvement of providing a part-assisted support adjunct to state-of-the-science self-help smoking cessation interventions for pregnant smokers. Ft. Bragg military base located in Fayetteville, NC was selected as the study site because of high smoking rates, high birth rates and the majority of women who receive prenatal care are married to military personnel. Three intervention conditions will be tested in an additive design. Eligible couples who are receiving prenatal care at Ft. Bragg/Womack Army Medical Center will be identified from automated appointment logs and recruited to participate. Couples who agree (n=700) will be randomized to: (1) provide advice and a self-help booklet (usual care prototype, n=233); (2) self-help guide and relapse prevention kit plus pre-and postpartum telephone counseling (enhanced self-help, n=233); or (3) enhanced self-help plus a partner-assisted support intervention that includes a couple contact session and tailored serialized written materials plus cessation materials for partner smokers (partner-assisted, n=233). Participants will be surveyed at baseline, 32 weeks of pregnancy, and 8 weeks, 6 and 12 months postpartum. Self reported smoking status will be biochemically validated late in pregnancy and at the 12 month follow-up. The primary outcomes of interest will be rates of smoking cessation among pregnant women and levels of perceived partner support for cessation at all follow-ups.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA076945-03
Application #
2896330
Study Section
Special Emphasis Panel (ZRG2-SSP (01))
Program Officer
Morgan, Glen D
Project Start
1997-09-26
Project End
2002-06-30
Budget Start
1999-07-01
Budget End
2000-06-30
Support Year
3
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Duke University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
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McBride, Colleen M; Baucom, Donald H; Peterson, Bercedis L et al. (2004) Prenatal and postpartum smoking abstinence a partner-assisted approach. Am J Prev Med 27:232-8
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Keefe, Francis J; Lipkus, Isaac; Lefebvre, John C et al. (2003) The social context of gastrointestinal cancer pain: a preliminary study examining the relation of patient pain catastrophizing to patient perceptions of social support and caregiver stress and negative responses. Pain 103:151-6
Pollak, Kathryn I; Namenek Brouwer, Rebecca J; Lyna, Pauline et al. (2003) Weight and smoking cessation among low-income African Americans. Am J Prev Med 25:136-9

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