The process of pregnancy smoking cessation: implications for interventions

DiClemente, Carlo C.; Dolan-Mullen, Patricia; Windsor, Richard A.

doi:10.1136/tc.9.suppl_3.iii16

Cited by 111 publications

(85 citation statements)

References 40 publications

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“…Pregnancy is a known "window of opportunity" (DiClemente, Dolan-Mullen, & Windsor, 2000, p. iii16) for behavior change given the intrinsic motivation of having a healthy baby.…”

Section: Discussionmentioning

confidence: 99%

Promoting Abstinence From Alcohol During Pregnancy: Implications From Formative Research

France

Donovan

Henley

et al. 2013

Substance Use & Misuse

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This research developed messages to promote abstinence from alcohol during pregnancy and identified elements that enhance message persuasiveness. An exploratory phase was conducted in 2009 that comprised four focus groups with 23 women in Western Australia and elicited beliefs and attitudes on alcohol use during pregnancy and motivations for behaviour change. Four television concepts were subsequently developed and appraised in five focus groups with 31 participants using standard advertising pretesting questions. The implications for campaigns addressing prenatal alcohol exposure and further research are noted and limitations discussed.

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“…Pregnancy is a known "window of opportunity" (DiClemente, Dolan-Mullen, & Windsor, 2000, p. iii16) for behavior change given the intrinsic motivation of having a healthy baby.…”

Section: Discussionmentioning

confidence: 99%

Promoting Abstinence From Alcohol During Pregnancy: Implications From Formative Research

France

Donovan

Henley

et al. 2013

Substance Use & Misuse

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“…5,21 Preparing women to move from an awareness of smoking on the developing baby to an effect on themselves is fundamental in maintaining cessation. 20,21 Pregnant smokers are more likely to come from the subgroup of women with lower socioeconomic status. 20 These women tend to have more psychological and emotional problems, less support and financial resources, more family problems, and less residential security.…”

Section: Profiles Of Women Who Smoke and Are Pregnantmentioning

confidence: 99%

“…In theory, pregnancy quitters might be more conscientious of their own health and their baby's health than spontaneous quitters and pregnant smokers and might be dedicated to remaining smoke-free not only for pregnancy but also for life. DiClemente et al 20 found that these women typically sustain cessation throughout the prenatal and postpartum period and that cessation rates on follow-up are dependent on their addiction (measured by number of ciga- rettes smoked per day, length of time between waking and smoking the first cigarette, etc) and motivation to quit. Spontaneous quitters generally have high cessation rates throughout the pregnancy (80% to 85%).…”

Section: Profiles Of Women Who Smoke and Are Pregnantmentioning

confidence: 99%

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Smoking Cessation in Pregnancy: A Review of Postpartum Relapse Prevention Strategies

Fang¹,

Goldstein

Butzen³

et al. 2004

The Journal of the American Board of Family Medicine

114

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Objective: Review and examine existing research, current strategies, and directions for future research on smoking cessation relapse and relapse prevention in pregnancy and postpartum.Methods: A MEDLINE/PubMed search in 2002 and 2003 for articles containing the key words "smoking," "pregnancy," "cessation," and "cessation relapse prevention" and references of retrieved papers yielded a review of more than 500 articles. Only 14 of these addressed program-based strategies to increase cessation among pregnant women through relapse prevention programs.Conclusion: Although there is much information on the rationale and strategies for smoking cessation for pregnant women, fewer studies exist on how to prevent relapse. Throughout the past decade, tobacco use has remained the single most important modifiable cause of poor pregnancy outcome in the United States. Smoking accounts for 20% of deliveries of infants with low birth weights, 8% of preterm births, and 5% of all perinatal deaths. Smoking during pregnancy and in postpartum contributes to sudden infant death syndrome and changes in brain and nervous system development. The direct medical costs of a complicated birth for a smoker are 66% higher than for nonsmokers. 1 Relapse rates range from 70% to 85% among women who smoke but quit at some time during their pregnancy. A recent 10-year study (1987 to 1996) of 8808 pregnant women and 178,499 nonpregnant women of childbearing age indicated that the prevalence of current smoking has decreased significantly among both pregnant (16.3% to 11.8%) and nonpregnant women (26.7% to 23.6%).2 This drop in smoking over time among pregnant women was primarily caused by the overall decline in smoking initiation rates among women of childbearing age, not by an increased rate of smoking cessation related to pregnancy.Although one fifth of pregnant smokers spontaneously quit by the time of their first antenatal visit, 3 and pregnant women are half as likely as nonpregnant women to be smokers, 2 an estimated 20.4% of women smokers continue smoking throughout their pregnancies. 4 For women who do quit during pregnancy and who received a planned intervention, between 6.2% and 37.2% remained smoke-free. The range of relapse rates is broad because of the varying success of the cessation intervention strategy. Between 29% and 85% of women who get a planned intervention relapse after delivery. 5-16Although there is much information on why and how pregnant women should quit, fewer data exist on how to prevent relapse. This article is a literature review on relapse and relapse prevention in pregnancy; we looked at existing research, current strategies, and directions for future research.

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“…Offsetting the pregnancy-related decrease in substance use is the precipitous increase that occurs during the 6 months to one year after delivery (Ebrahim and Gfroerer, 2003;Gilchrist et al, 1996;Howell et al, 1999). For example, close to half of women who attain abstinence to smoking in pregnancy relapse within two weeks of delivery (Colman and Joyce, 2003), and 80% relapse within six months (DiClemente et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Perinatal substance use: A prospective evaluation of abstinence and relapse

Forray

Merry

Lin

et al. 2015

Drug and Alcohol Dependence

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Background-Substance use decreases in pregnancy but little prospective data are available on the rates of abstinence and relapse for specific substances. This study compared rates of abstinence in pregnancy and relapse postpartum for nicotine cigarettes, alcohol, marijuana, and cocaine.Methods-Data from 152 women drawn from a randomized controlled trial comparing psychological treatments for substance use in pregnancy were analyzed. Self-reports of substance use and urine for toxicology testing throughout pregnancy and 3-months, 12-months and 24-months post-delivery were collected. Multivariate Cox models were used to compare rates of abstinence and relapse across substances.Results-In pregnancy, 83% of all women achieved abstinence to at least one substance. The mean (SE) days to abstinence was 145.81 (9.17), 132.01 (6.17), 151.52 (6.24), and 148.91 (7.68) for cigarettes, alcohol, marijuana and cocaine, respectively. Participants were more likely to achieve abstinence from alcohol (HR 7.24 (95% CI 4.47-11.72), marijuana (HR 4.06; 95% CI 1.87-6.22), and cocaine (HR 3.41; 95% CI 2.53-6.51), than cigarettes. Postpartum, 80% of women © 2015 Published by Elsevier Ltd.Please address correspondence to Ariadna Forray at: 40 Temple Street, Suite 6B, New Haven, Connecticut, 06510 USA Fax: (203) 764-6766; ariadna.forray@yale.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Contributors:Drs. Yonkers and Ruger were responsible for the conduct of the study. Drs. Forray, Yonkers, Lin and Mr. Merry were responsible for the statistical analyses and interpretation of the data. Dr. Forray was responsible for initial draft of the manuscript, with contributions from Dr. Yonkers and Mr. Merry. Drs. Forray, Yonkers, Ruger, Lin, and Mr. Merry were responsible for critical review and editing of the manuscript. Conflict of Interest:In the past year, Dr. Yonkers received royalties from Up To Date, the content of which has no relationship to this project. Drs. Forray, Ruger, Lin and Mr. Merry have nothing to disclose. Conclusions-Pregnancy-related abstinence rates were high for all substances except cigarettes. Postpartum relapse was common, with cocaine using women being less likely to relapse after attaining abstinence compared to women using cigarettes, alcohol or marijuana. HHS Public Access

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The process of pregnancy smoking cessation: implications for interventions

Cited by 111 publications

References 40 publications

Promoting Abstinence From Alcohol During Pregnancy: Implications From Formative Research

Promoting Abstinence From Alcohol During Pregnancy: Implications From Formative Research

Smoking Cessation in Pregnancy: A Review of Postpartum Relapse Prevention Strategies

Perinatal substance use: A prospective evaluation of abstinence and relapse

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