Impact of a motivational intervention on mechanisms of change in low-income pregnant smokers.

Numerous smoking cessation interventions targeting pregnant women have been developed and tested. An overall increase in smoking cessation is indicated, yet quit rates are modest and variable. Although efficacious with other substance abuse populations, motivational interviewing (MI) interventions with pregnant smokers have resulted in marginal outcomes. Examining treatment mechanisms affected by MI interventions may assist in understanding negative results and in developing more innovative and effective interventions. This study assessed the impact of an MI intervention on transtheoretical (TTM)-based mechanisms of change in low-income pregnant smokers (N = 54). Repeated measures analyses indicated that relative to usual care (UC), pregnant smokers who received MI reported a greater increase in confidence to abstain from smoking, a decrease in temptation to smoke, and a decrease in level of depression. However, the MI intervention was not associated with forward progression in the stages of change. More intensive motivational and cognitive-behavioral interventions demonstrated effective in nonpregnant, smoking populations, with more frequent sessions separate from prenatal visits, are recommended to further increase smoking cessation rates among low-income pregnant smokers.