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American Journal of Public Health, Vol. 85, Issue 2 217-222, Copyright © 1995 by American Public Health Association

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Integrating smoking cessation into routine public prenatal care: the Smoking Cessation in Pregnancy project.

J S Kendrick, S C Zahniser, N Miller, N Salas, J Stine, P M Gargiullo, R L Floyd, F W Spierto, M Sexton and R W Metzger

Centers for Disease Control and Prevention, Atlanta, Ga 30341-3724.

OBJECTIVES. In 1986, the state health departments of Colorado, Maryland, and Missouri conducted a federally-funded demonstration project to increase smoking cessation among pregnant women receiving prenatal care and services from the Women, Infants, and Children (WIC) program in public clinics. METHODS. Low-intensity interventions were designed to be integrated into routine prenatal care. Clinics were randomly assigned to intervention or control status; pregnant smokers filled out questionnaires and gave urine specimens at enrollment, in the eighth month of pregnancy, and postpartum. Urine cotinine concentrations were determined at CDC by enzyme-linked immunosorbent assay and were used to verify self-reported smoking status. RESULTS. At the eighth month of pregnancy, self-reported quitting was higher for intervention clinics than control clinics in all three states. However, the cotinine-verified quit rates were not significantly different. CONCLUSIONS. Biochemical verification of self-reported quitting is essential to the evaluation of smoking cessation interventions. Achieving changes in smoking behavior in pregnant women with low-intensity interventions is difficult.




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