DESCRIPTION: Smoking during pregnancy increases women's risk of
complications of pregnancy and numerous birth outcomes. Two-thirds of women
smokers continue to smoke during pregnancy, with particularly high rates of
smoking among low income and less educated women. For the majority of
women, pregnancy occurs in the context of an intimate relationship that
pregnant women report as their primary source of support. However,
naturally occurring partner support may not be enough to assist pregnant
smokers with cessation, particularly when the partner is a smoker. The
proposed study is a five year randomized trial to evaluate the incremental
improvement of providing a part-assisted support adjunct to
state-of-the-science self-help smoking cessation interventions for pregnant
smokers. Ft. Bragg military base located in Fayetteville, NC was selected
as the study site because of high smoking rates, high birth rates and the
majority of women who receive prenatal care are married to military
personnel. Three intervention conditions will be tested in an additive
design. Eligible couples who are receiving prenatal care at Ft.
Bragg/Womack Army Medical Center will be identified from automated
appointment logs and recruited to participate. Couples who agree (n=700)
will be randomized to: (1) provide advice and a self-help booklet (usual
care prototype, n=233); (2) self-help guide and relapse prevention kit plus
pre-and postpartum telephone counseling (enhanced self-help, n=233); or (3)
enhanced self-help plus a partner-assisted support intervention that
includes a couple contact session and tailored serialized written materials
plus cessation materials for partner smokers (partner-assisted, n=233).
Participants will be surveyed at baseline, 32 weeks of pregnancy, and 8
weeks, 6 and 12 months postpartum. Self reported smoking status will be
biochemically validated late in pregnancy and at the 12 month follow-up.
The primary outcomes of interest will be rates of smoking cessation among
pregnant women and levels of perceived partner support for cessation at all
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