Prevention of relapse in women who quit smoking during pregnancy

Objectives. This study is an evaluation of relapse prevention interventions for smokers who quit during pregnancy. Methods. Pregnant smokers at 2 managed care organizations were randomized to receive a self-help booklet only, prepartum relapse prevention, or prepartum and postpartum relapse prevention. Follow-up surveys were conducted at 28 weeks of pregnancy and at 8 weeks, 6 months, and 12 months post-partum. Results. The pre/post intervention delayed but did not prevention postpartum relapse to smoking. Prevalent abstinence was significantly grater for the pre post intervention group than for the other groups at 8 weeks (booklet group, 30%, prepartum group, 35%, pre/post group 39%; P = .02 [different superscripts denote differences at P < .05]) and at 6 months (booklet group, 26%; prepartum group, 24%; pre/post group, 33%; P = .04) postpartum. A nonsignificant reduction in relapse among the pre post group contributed to differences in prevalent abstinence. There was no difference between the groups in prevalent abstinence at 12 months postpartum. Conclusions. Relapse prevention interventions may need to be increased in duration and potency to prevent postpartum relapse.