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Smoking status in the initial weeks of quitting as a predictor of smoking-cessation outcomes in pregnant women.

Higgins ST, Heil SH, Dumeer AM, Thomas CS, Solomon LJ, Bernstein IM

Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA. stephen.higgins@uvm.edu

OBJECTIVE: Any smoking during the initial 2 weeks of attempting to quit predicts poor short- and longer-term outcomes in the general population of cigarette smokers. The present study examined whether that rule applies to pregnant women. METHODS: Data were obtained from 129 women participating in clinical trials on smoking-cessation examining the efficacy of voucher-based incentives delivered contingent on biochemically-verified abstinence or a control condition wherein incentives were given independent of smoking status. Smoking status was assessed in weeks 1 and 2 of the cessation effort and again at an end-of-pregnancy assessment scheduled at weeks 28-32 gestation using self-report and biochemical verification. RESULTS: Smoking in weeks 1 or 2 predicted smoking at the end-of pregnancy assessment independent of treatment condition. There was a 79% and 92% chance that those who smoked in weeks 1 or 2 would be classified as smokers at end-of-pregnancy in the contingent-incentive and control conditions, respectively. CONCLUSIONS: Clinicians assisting pregnant women trying to quit smoking may want to monitor progress in the initial weeks of the cessation effort and consider enhancing/changing the intervention when smoking is detected.

Published 2 October 2006 in Drug Alcohol Depend, 85(2): 138-41.
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