Preventing Postpartum Smoking Relapse: A Randomized Clinical Trial

Area of Science:

• Public Health
• Behavioral Science
• Women's Health

Background:

• Most women who quit smoking during pregnancy relapse postpartum.
• Previous interventions to prevent postpartum relapse have been unsuccessful.
• Effective strategies for sustained postpartum smoking abstinence are needed.

Purpose of the Study:

• To evaluate the relative efficacy of two different approaches to prevent postpartum smoking relapse.
• To assess an enhanced cognitive behavioral intervention (STARTS) compared to a supportive, time and attention-controlled comparison (SUPPORT).

Main Methods:

• Pregnant women who recently quit smoking were recruited before delivery.
• Participants received postpartum-adapted behavioral interventions from delivery through 24 weeks postpartum.
• The primary outcome was biochemically confirmed sustained tobacco abstinence at 52 weeks postpartum.

Main Results:

• No significant differences in abstinence rates or time to relapse were found between the STARTS and SUPPORT groups.
• Overall abstinence rates at 52 weeks postpartum were 24.0%.
• Improvements in mood and stress were observed in both groups, and lower levels of depressive symptoms and stress were associated with sustained abstinence.

Conclusions:

• The STARTS intervention did not improve postpartum smoking abstinence rates compared to the control.
• Postpartum mood and stress improvements were noted in both groups.
• Future interventions should target postpartum mood and stress to improve sustained smoking abstinence.