Integrating smoking cessation into routine public prenatal care: the Smoking Cessation in Pregnancy project

Am J Public Health. 1995 Feb;85(2):217-22. doi: 10.2105/ajph.85.2.217.


Objectives: In 1986, the state health departments of Colorado, Maryland, and Missouri conducted a federally-funded demonstration project to increase smoking cessation among pregnant women receiving prenatal care and services from the Women, Infants, and Children (WIC) program in public clinics.

Methods: Low-intensity interventions were designed to be integrated into routine prenatal care. Clinics were randomly assigned to intervention or control status; pregnant smokers filled out questionnaires and gave urine specimens at enrollment, in the eighth month of pregnancy, and postpartum. Urine cotinine concentrations were determined at CDC by enzyme-linked immunosorbent assay and were used to verify self-reported smoking status.

Results: At the eighth month of pregnancy, self-reported quitting was higher for intervention clinics than control clinics in all three states. However, the cotinine-verified quit rates were not significantly different.

Conclusions: Biochemical verification of self-reported quitting is essential to the evaluation of smoking cessation interventions. Achieving changes in smoking behavior in pregnant women with low-intensity interventions is difficult.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cotinine / urine
  • Educational Status
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Marriage
  • Parity
  • Pregnancy
  • Prenatal Care / methods*
  • Smoking / epidemiology
  • Smoking Cessation*
  • Tobacco Smoke Pollution
  • United States / epidemiology


  • Tobacco Smoke Pollution
  • Cotinine