Efficacy and cost-effectiveness of a clinic-based counseling intervention tested in an ethnically diverse sample of pregnant smokers

Patient Educ Couns. 2006 Dec;64(1-3):342-9. doi: 10.1016/j.pec.2006.03.015. Epub 2006 Jul 21.


Objective: Rates of cigarette smoking are higher among women who receive obstetric care through publicly funded prenatal clinics. This study compared smoking outcomes for pregnant women (n=105) who were randomized to receive either usual care (standard cessation advice from the health care provider) or an intervention conducted in the prenatal clinic consisting of 1.5 h of counseling plus telephone follow-up delivered by a masters prepared mental health counselor.

Methods: Subjects were 105 low income, predominantly Hispanic, pregnant patients in an urban prenatal clinic. Smoking outcomes were assessed at end of pregnancy and 6 months post-partum.

Results: At follow-up, 28.3% and 9.4% of participants in the experimental intervention and 9.6% and 3.8% of patients in usual care were abstinent at end of pregnancy (p=.015) and 6 months post-partum, respectively (p=.251). Cost of the intervention was $56 per patient and cost to produce a non-smoker at end of pregnancy was $299.

Conclusions: This model for intervention was cost-effective and was associated with significantly lower smoking rates at end of pregnancy.

Practical implications: If these findings are replicated, prenatal clinics could offer the option for intensive smoking cessation treatment by training mental health counselors to deliver one extended smoking cessation counseling session.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • African Americans / education
  • African Americans / ethnology
  • Aftercare / organization & administration
  • Aftercare / psychology
  • Ambulatory Care / organization & administration
  • Ambulatory Care / psychology
  • Attitude to Health / ethnology
  • Connecticut / epidemiology
  • Cost-Benefit Analysis
  • Counseling / organization & administration*
  • Cultural Diversity
  • European Continental Ancestry Group / education
  • European Continental Ancestry Group / ethnology
  • Female
  • Health Knowledge, Attitudes, Practice
  • Hispanic Americans / education
  • Hispanic Americans / ethnology
  • Humans
  • Patient Education as Topic / organization & administration
  • Postnatal Care / organization & administration
  • Postnatal Care / psychology
  • Pregnancy
  • Pregnancy Complications / ethnology
  • Pregnancy Complications / prevention & control*
  • Prenatal Care / organization & administration*
  • Prevalence
  • Program Evaluation
  • Psychotherapy, Brief / organization & administration*
  • Smoking / ethnology
  • Smoking Cessation / ethnology
  • Smoking Cessation / methods
  • Smoking Prevention*
  • Telephone
  • Treatment Outcome