Smoking status in the initial weeks of quitting as a predictor of smoking-cessation outcomes in pregnant women

Abstract

Objective Any smoking during the initial 2 weeks of attempting to quit predicts poor short- and longer-term outcomes in the general population of cigarette smokers. The present study examined whether that rule applies to pregnant women. Methods Data were obtained from 129 women participating in clinical trials on smoking-cessation examining the efficacy of voucher-based incentives delivered contingent on biochemically-verified abstinence or a control condition wherein incentives were given independent of smoking status. Smoking status was assessed in weeks 1 and 2 of the cessation effort and again at an end-of-pregnancy assessment scheduled at weeks 28–32 gestation using self-report and biochemical verification. Results Smoking in weeks 1 or 2 predicted smoking at the end-of pregnancy assessment independent of treatment condition. There was a 79% and 92% chance that those who smoked in weeks 1 or 2 would be classified as smokers at end-of-pregnancy in the contingent-incentive and control conditions, respectively. Conclusions Clinicians assisting pregnant women trying to quit smoking may want to monitor progress in the initial weeks of the cessation effort and consider enhancing/changing the intervention when smoking is detected.