An ideal time to help underserved young women to stop smoking cigarettes and remain abstinent for life is during pregnancy. The field has made great progress in assisting women to quit during this time. Unfortunately, maintenance of this highly significant behavior change is dismal with up to 75% of those who quit for pregnancy returning to smoking after delivery of the newborn. Especially for underserved women, pregnancy is one of the few times that they have an extended contact with the health care system and thus, we have the opportunity not only to help then quit smoking for the health of their fetus but for their own long term health as well. To date, there has been insufficient research on how best to maintain abstinence during the critical postpartum period, where a unique constellation of risk factors, including sleep deprivation, variations in negative mood, and increased stress heighten the probability of relapse. The potential payoff is enormous. The literature, while not extensive, provides sufficient guidance and justification for the specific approach and intervention components we have chosen. Also, to both increase and to better understand maintenance of abstinence and our research team has the experience and well established relationships with more than enough prenatal clinics to successfully implement the research design as proposed. Thus, we are proposing to develop and field test a maintenance of smoking abstinence program to be designed for a predominately low-income, high-risk population of women from a wide variety of ethnic/racial backgrounds who have quit smoking because of (or during) their pregnancy.
The Specific Aims of the current maintenance study are: 1) To compare biochemically confirmed smoking abstinence rates of women who quit smoking during their pregnancy and who receive an intervention based on telephone counseling using motivational interviewing versus quitters who receive usual care. Maintenance of abstinence will be assessed at 1, 3, 6, and 9 months postpartum. (2) To collect both qualitative and quantitative data to better understand short term and long term maintenance mediators and moderators of abstinence postpartum for low SES women who quit smoking during pregnancy. ? ?
