Quitting for Keeps: Promoting cessation & preventing relapse among pregnant and postpartum WIC clients

Problem: Smoking during pregnancy is the most preventable cause of illness and death among mothers and infants. Pregnancy, however, offers a unique “window of opportunity” when between 40-60% of women spontaneously quit. Unfortunately, 50% resume smoking within 6 months postpartum and 80% within the first year. Creating systems that support and enhance tobacco cessation and relapse prevention among pregnant and postpartum women takes advantage of an important opportunity to realize long-term public health benefits. Method: Quitting for Keeps, a community-based participatory research project, is a modified 5As cessation and relapse prevention intervention developed specifically for and with WIC staff and clients. Focus group data was collected from the target audiences and used to collaboratively develop staff training and client materials tailored specifically for WIC. Staff were trained in the provision of a brief 3As intervention technique and follow-up evaluation was conducted with clients at 6 weeks, 6 months, and 12 months. Results: To date, 103 interventions have been reported with an intervention rate of approximately 88%. Of these, 23% resulted in clients setting a quit date. Six-week follow up evaluations show 84% of clients found the intervention somewhat or very useful. Of those who had not yet quit, 71% reported they were seriously considering it in the next 30 days. Those that had quit reported high confidence they would remain quit. Conclusion: Systematic cessation and relapse prevention training among WIC staff can successfully increase counseling practices and decrease tobacco use and relapse among low income pregnant and postpartum women.