DESCRIPTION: Smoking continues to be the most preventable cause of death
and disability in the United States. As many as 87 percent of lung cancer
deaths are secondary to smoking, as well as 30 percent of all cancer deaths.
The mortality trends in lung cancer rates for women are rising more rapidly
than for men and lung cancer is the leading cause of death from cancers in
women. Given the mortality trends in lung cancer for women and the link to
their smoking patterns, cancer prevention efforts should focus on targeting
high risk female mothers as well as take advantage of teachable moments to
best accelerate progress toward smoking cessation in women.
Economically disadvantaged pregnant women are both more likely to smoke
prior to becoming pregnant and less likely to quit during pregnancy than
other women of childbearing age. Even when they do quit during pregnancy,
they are likely to relapse postpartum. Therefore, pregnancy and the
postpartum period is an important window of opportunity for interventions to
motivate these women and accelerate their progress toward smoking cessation.
Reducing smoking in pregnancy and postpartum would serve to reduce health
risks for two individuals, mother and child, thereby, promote the cancer
prevention objectives set forth in Healthy People 2000.
The proposed project is a collaborative effort of the Cancer Prevention
Research Consortium at the University of Rhode Island and the Women and
Infants Hospital of Rhode Island, a teaching hospital of Brown University
Medical School. The proposed study is designed to evaluate the impact of an
innovative stage-based individualized, interactive intervention
(Individualized Intervention) on smoking cessation compared with a
stage-matched self-help approach (self-help Intervention) and a standard
care condition. The Individualized and self-help Interventions will be
based on existing theoretical concepts and behavior change techniques of the
Transtheoretical Model. The target population will be low-income culturally
diverse pregnant women attending public maternity clinics. The proposed
study will involve a prospective randomized, three-group, repeated measures
Information gained from the project data will help determine the efficacy of
this innovative smoking cessation intervention, identify the impact of the
intervention on intermediate or process variables, and provide insight into
the influence of pregnancy and delivery on readiness for changing smoking
behaviors. The benefits of promoting smoking cessation programs during
pregnancy will not only have a long-range impact on the individual, but also
on the overall health of the family.
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