Health education for pregnant smokers: its behavioral impact and cost benefit.

OBJECTIVES A randomized trial (the Birmingham Trial II) was conducted to evaluate the behavioral impact of health education methods among 814 female smokers at four public health maternity clinics. METHODS Four hundred patients were randomly assigned to an Experimental (E) Group, and 414 were assigned to a Control (C) Group. Self-reports and saliva cotinine tests confirmed smoking status at the first visit, at midpregnancy, and at end of pregnancy. RESULTS The E Group exhibited a 14.3% quit rate and the C Group an 8.5% quit rate. A Historical Comparison (C) Group exhibited a 3.0% quit rate. Black E and C Group patients had higher quit rates than White E and C Group patients. A cost-benefit analysis found cost-to-benefit ratios of $1:$6.72 (low estimate) and $1:$17.18 (high estimate) and an estimated savings of $247,296 (low estimate) and $699,240 (high estimate). CONCLUSION Health education methods are efficacious and cost beneficial for pregnant smokers in public health maternity clinics.

[1]  R. Windsor,et al.  The dissemination of smoking cessation methods for pregnant women: achieving the year 2000 objectives. , 1993, American journal of public health.

[2]  A. Washington,et al.  Estimation of the break-even point for smoking cessation programs in pregnancy. , 1992, American journal of public health.

[3]  R. Etzel.  A review of the use of saliva cotinine as a marker of tobacco smoke exposure. , 1990, Preventive medicine.

[4]  D. Jacobs,et al.  Racial differences in serum cotinine levels among smokers in the Coronary Artery Risk Development in (Young) Adults study. , 1990, American journal of public health.

[5]  J. Mayer,et al.  A randomized evaluation of smoking cessation interventions for pregnant women at a WIC clinic. , 1990, American journal of public health.

[6]  P. Mullen,et al.  A randomized trial of a serialized self-help smoking cessation program for pregnant women in an HMO. , 1989, American journal of public health.

[7]  G H Land,et al.  The effects of maternal smoking on fetal and infant mortality. , 1988, American journal of epidemiology.

[8]  J. Pierce,et al.  Cotinine validation of self-reported smoking in commercially run community surveys. , 1987, Journal of chronic diseases.

[9]  R. Windsor,et al.  Guidelines and Methodological Standards for Smoking Cessation Intervention Research among Pregnant Women: Improving the Science and Art , 1986, Health education quarterly.

[10]  G. Cutter,et al.  The effectiveness of smoking cessation methods for smokers in public health maternity clinics: a randomized trial. , 1985, American journal of public health.

[11]  N. Haley,et al.  Validation of self-reported smoking behavior: biochemical analyses of cotinine and thiocyanate. , 1983, American journal of public health.