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Smoking cessation among low-income pregnant women: Results from the New England SCRIPT study

Donna R Parker, ScD, Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860, 401-729-2531, Donna_Parker@Brown.edu, Thomas M. Lasater, PhD, Institute for Community Health Promotion, Brown University, 1 Hoppin St., Coro 4-West, Providence, RI 02903, and Richard A. Windsor, PhD, School of Public Health and Health Services, George Washington University, 2175 K Street NW #810, Washington, DC 20037.

Cigarette smoking during pregnancy is of great concern because it affects both the health of the mother and the fetus. We examined methods of assisting low-income, multi-ethnic pregnant women to quit smoking and remain smoke-free using one of 3 smoking cessation programs differing in complexity and cost. Pregnant smokers interested in participating received a Quit Kit at their first prenatal visit. After completing a baseline telephone survey, the participant was randomly assigned to one of 3 groups: 1=Quit Kit (QK), 2= QK & participation in a Quit and Win Contest (Q&W) and 3=QK, Q&W, and 3 motivational interview phone calls. Smoking status was assessed at baseline, 32 weeks gestation, and 6 months postpartum. To confirm self-reported smoking status, urine samples were obtained (to test for cotinine). We examined the effectiveness of the 3 groups by comparing smoking status at 32 weeks gestation. A total of 917 women recruited from medical facilities in New England were assessed. The self-reported quit rates were: 26.4%, 22.6%, and 31% for Groups 1, 2 and 3, respectively (p=.07). We also examined data by race/ethnicity. Compared to Black and Hispanic women, White women were more likely to live with a smoker and more likely to smoke significantly more cigarettes/day. Self-reported quit rates in each group were surprisingly high. Based upon these data, it is not apparent that adding the Q&W contest and motivational interviewing is worth the resources that are required. There also appeared to be differences based upon racial/ethnic subgroups which are currently being examined.

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