Addressing Postpartum Smoking Relapse Among Low-Income Women: A Randomized Control Trial

Area of Science:

• Public Health
• Maternal and Child Health
• Addiction Medicine

Background:

• Smoking during pregnancy poses significant risks to maternal and infant health.
• Low-income pregnant women exhibit high smoking prevalence.
• Postpartum smoking relapse rates are notably high among women who quit during pregnancy.

Purpose of the Study:

• To evaluate the effectiveness of adding postpartum assistance to an established smoking cessation program for low-income pregnant women.
• To reduce postpartum smoking relapse rates in a vulnerable population.

Main Methods:

• A randomized control trial involving 185 low-income pregnant women.
• Standard group received evidence-based prenatal smoking cessation counseling.
• Enhanced group received standard care plus postpartum in-home visits, counseling calls, household support, and incentives ($100 in gift cards).
• Primary outcome: biochemically verified smoking abstinence at 6 months postpartum.

Main Results:

• Among completers, the intervention group achieved a 36.6% abstinence rate versus 12.3% in the control group (P<0.01).
• On an intent-to-treat basis, the intervention group showed a 16.5% abstinence rate compared to 7.4% in the control group (P=0.07).

Conclusions:

• Extending smoking cessation interventions into the postpartum period is a viable strategy to combat relapse.
• Postpartum support is crucial for sustained smoking abstinence among women who quit during pregnancy.