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Randomized Controlled Trial
. 2010 Apr;12(4):326-35.
doi: 10.1093/ntr/ntq001. Epub 2010 Feb 12.

Preventing postpartum smoking relapse among diverse low-income women: a randomized clinical trial

Lorraine R Reitzel  1 , Jennifer Irvin Vidrine, Michael S Businelle, Darla E Kendzor, Tracy J Costello, Yisheng Li, Patricia Daza, Patricia Dolan Mullen, Mary M Velasquez, Paul M Cinciripini, Ludmila Cofta-Woerpel, David W Wetter
Affiliations
Randomized Controlled Trial

Preventing postpartum smoking relapse among diverse low-income women: a randomized clinical trial

Lorraine R Reitzel et al. Nicotine Tob Res. 2010 Apr.

Abstract

Introduction: Postpartum relapse rates are high among women who spontaneously quit smoking during pregnancy. This randomized clinical trial tested a Motivation and Problem-Solving (MAPS) treatment for reducing postpartum relapse among diverse low-income women who quit smoking during pregnancy (N = 251; 32% Black, 30% Latino, and 36% White; 55% <$30,000/year household income).

Methods: Pregnant women were randomly assigned to MAPS/MAPS+ or Usual Care (UC). Continuation ratio logit models were used to examine differences in biochemically confirmed continuous abstinence at Weeks 8 and 26 postpartum by treatment group and moderators of the treatment effect. Analyses controlled for age, race/ethnicity, partner status, education, smoking rate, and the number of smokers in the participant's environment.

Results: MAPS/MAPS+ was more efficacious than UC in the prevention of postpartum relapse (p = .05). An interaction between treatment and the number of cigarettes smoked per day before quitting approached significance (p = .09), suggesting that the MAPS/MAPS+ treatment effect was stronger among women who smoked more cigarettes per day.

Discussion: MAPS, a holistic and dynamic approach to changing behavior using a combined motivational enhancement and social cognitive approach, is a promising intervention for postpartum smoking relapse prevention among low-income women, which may have particular relevance for women with higher prequit smoking rates.

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Figures

Figure 1.
Figure 1.
CONSORT flowchart of recruitment and attendance at follow-up appointments.
Figure 2.
Figure 2.
Abstinence rates by treatment group at 8 and 26-weeks postpartum.
Figure 3.
Figure 3.
Illustration of the interaction effect of treatment group with prequit cigarettes per day (CPD) in unadjusted analyses.
See this image and copyright information in PMC

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