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Health education for pregnant smokers: its behavioral impact and cost benefit.

R A Windsor, J B Lowe, L L Perkins, D Smith-Yoder, L Artz, M Crawford, K Amburgy and N R Boyd, Jr

School of Public Health, University of Alabama, Birmingham.

OBJECTIVES. A randomized trial (the Birmingham Trial II) was conducted to evaluate the behavioral impact of health education methods among 814 female smokers at four public health maternity clinics. METHODS. Four hundred patients were randomly assigned to an Experimental (E) Group, and 414 were assigned to a Control (C) Group. Self-reports and saliva cotinine tests confirmed smoking status at the first visit, at midpregnancy, and at end of pregnancy. RESULTS. The E Group exhibited a 14.3% quit rate and the C Group an 8.5% quit rate. A Historical Comparison (C) Group exhibited a 3.0% quit rate. Black E and C Group patients had higher quit rates than White E and C Group patients. A cost-benefit analysis found cost-to-benefit ratios of $1:$6.72 (low estimate) and $1:$17.18 (high estimate) and an estimated savings of $247,296 (low estimate) and $699,240 (high estimate). CONCLUSION. Health education methods are efficacious and cost beneficial for pregnant smokers in public health maternity clinics.

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