Smoking patterns and use of cessation interventions during pregnancy.

BACKGROUND: Pregnant smokers should be counseled to quit smoking and offered effective cessation interventions. To improve understanding of how best to increase smoking-cessation rates during pregnancy, this study analyzed population-based surveillance data to describe women's smoking patterns and the use of cessation services during pregnancy.
METHODS: Data were analyzed from the 2004 and 2005 New Jersey Pregnancy Risk Assessment Monitoring System, a population-based survey of postpartum women (n=4473). Measures of behaviors included the timing of quit relative to the learning of pregnancy, provider assistance, the use of cessation interventions, and barriers to quitting. Analyses were done in 2007 and 2008.
RESULTS: An estimated 16.2% (95% CI=15.1, 17.3) of women smoked before pregnancy. Of these, 49.8% quit before entering prenatal care, and 5.2% quit after entering prenatal care. Almost all women reported that their prenatal care provider asked if they smoked, but only 56.7% reported that a provider counseled them to quit smoking. Only 11.5% of women who smoked in late pregnancy used a cessation method, including self-help materials (6.3%); medications (3.9%); face-to-face counseling (1.7%); telephone-based counseling (1.5%); Internet-based counseling (1.3%); and a class or program (1.0%). The most frequently reported barriers to quitting were cravings for a cigarette, stress, and being around people who smoked.
CONCLUSIONS: Nearly half of pregnant New Jersey smokers quit before prenatal care, and very few quit later. Few continuing smokers used a smoking-cessation method when trying to quit or cut back. Efforts should be intensified to increase the knowledge, promotion, and referral to effective interventions to help pregnant smokers quit.