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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.144485v1 99/5/893    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kim, S. Y. Articles by Callaghan, W. M. Search for Related Content PubMed PubMed Citation Articles by Kim, S. Y. Articles by Callaghan, W. M. Related Collections Pregnancy Smoking Cessation Tobacco Control

Shin Y. Kim, MPH, Lucinda J. England, MD, MSPH, Juliette S. Kendrick, MD, Patricia M. Dietz, DrPH and William M. Callaghan, MD, MPH

The authors are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.

Correspondence: Request for reprints should be made to Shin Y. Kim, 4770 Buford Hwy NE, MS K-23, Atlanta, GA 30341 (e-mail: skim1{at}cdc.gov).

Objectives. We sought to estimate the effect of universal implementation of a clinic-based, psychosocial smoking cessation intervention for pregnant women.

Methods. We used data from US birth certificates (2005) and the Pregnancy Risk Assessment Monitoring System (2004) to estimate the number of women smoking at conception. To calculate the number of women eligible to receive the cessation intervention, we used estimates from the literature of the percentage of women who quit spontaneously (23%), entered prenatal care before the third trimester (96.5%), and disclosed smoking to their provider (75%). We used the pooled relative risk (RR) for continued smoking from the 2004 Cochrane Review as our measure of the intervention's effectiveness (RR = 0.94).

Results. We estimated that 944 240 women smoked at conception. Of these, 23.0% quit spontaneously, 6.3% quit with usual care, and an additional 3.3% quit because of the intervention, leaving 67.4% smoking throughout pregnancy. The calculated smoking prevalence in late pregnancy decreased from 16.4% to 15.6% because of the intervention.

Conclusions. Universal implementation of a best-practice, clinic-based intervention would increase the total number of quitters but would not substantially reduce smoking prevalence among pregnant women.