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Self-help booklets for preventing postpartum smoking relapse: a randomized trial.

Thomas H Brandon1, Vani Nath Simmons, Cathy D Meade

  • 1Tobacco Research & Intervention Program, Moffitt Cancer Center, 4115 E. Fowler Ave., Tampa, FL 33617, USA. thomas.brandon@moffitt.org

American Journal of Public Health
|September 22, 2012
PubMed
Summary

Self-help booklets effectively prevented postpartum smoking relapse in lower-income women. This low-cost intervention significantly increased abstinence rates for this vulnerable group.

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Area of Science:

  • Public Health
  • Behavioral Science
  • Maternal Health

Background:

  • Postpartum smoking relapse is a significant public health concern.
  • Effective interventions are needed to support smoking cessation in pregnant and postpartum women.
  • Self-help materials offer a scalable approach to relapse prevention.

Purpose of the Study:

  • To evaluate the efficacy of "Forever Free for Baby and Me" (FFB) self-help booklets in preventing postpartum smoking relapse.
  • To compare FFB effectiveness against usual care control (UCC) among pregnant women who quit smoking.
  • To examine if treatment effects are moderated by socioeconomic factors like income and age.

Main Methods:

  • A randomized controlled trial involving 504 pregnant women (recruited between 4-8 months gestation) who had quit smoking.
  • Participants were assigned to receive either 10 FFB booklets mailed until 8 months postpartum or UCC.
  • Assessments of smoking abstinence were conducted at baseline, and 1, 8, and 12 months postpartum.

Main Results:

  • A significant main effect for treatment was observed at 8 months postpartum, with higher abstinence rates in the FFB group (69.6%) compared to UCC (58.5%).
  • Treatment efficacy was moderated by annual household income; lower-income women (<$30,000) showed significant benefits from FFB at 8 and 12 months postpartum (72.2% and 72.1% abstinence, respectively).
  • No significant treatment effects were found for higher-income women.

Conclusions:

  • Self-help booklets (FFB) are efficacious in preventing postpartum smoking relapse, particularly for low-income women.
  • FFB represents a low-cost, accessible intervention for relapse prevention assistance.
  • Targeted self-help interventions may be crucial for improving cessation outcomes in specific socioeconomic groups.