EDITORIAL COMMENT: The takeaway message from this sophisticated audit of smoking behaviour of pregncny Seems to be that during pregnancy. seems to be that spontaneous quitters who lapse back to the habit should be identifed, since they comprise about 35% of smokers who a n likely to quit after counselling during pregnancy. This paper gives important insight into the logistics of planning a policy of prevention of smoking during prenancy. We await, with interest, the authors' findings in their randomized controlled trial of a smoking cessation intervention

Summary: Spontaneous quitters are prepregnancy smokers who quit by the time of their first antenatal visit. We recruited 192 self-declared spontaneous quitters and 407 smokers at their first visit to the antenatal clinic at the Royal Women's Hospital during April, 1994-May, 1995. Spontaneous quitters made up 23% of prepregnancy smokers. Information about self-declared quitters and smokers was collected by self-completed questionnaires. Urine samples collected at the first visit and in late pregnancy were assayed for cotinine to validate smoking status. A cut-off urinary concentration of >653 nmol/L cotinine was used to determine active smoking. At the first visit, 20% of the self-declared spontaneous quitters were smoking and by late pregnancy, regardless of their initial biochemically verified status, 27% were smoking. Spontaneous quitters were different from women who said they were still smoking at their first antenatal visit, in a range of demographic variables and measures of addictive behaviour.