ABSTRACT: About one-third of women enter their pregnancies as smokers. Attempts to help those who do not quit on their own have not been effective. As part of a 3-year study to test the hypothesis that smoking reduction during pregnancy improves the birthweight of the infant (an hypothesis which was confirmed), a smoking intervention program was developed that resulted in a twofold increase in the percentage of women who stopped smoking cigarettes during their pregnancy. There was no comparative evaluation of the different kinds of intervention activities that were used, but because they were successful in the aggregate, they are described here and a judgment made of the effectiveness of the different components.

The main method of contact for the counseling was a single face-to-face session at the smoker's home, followed by frequent phone contacts. Although information was given on the risks of smoking during pregnancy, the emphasis was on how to stop through the use of behavioral skills such as developing commitment, self-monitoring, stimulus control, substitute and incompatible behaviors, and positive associations with not smoking. A series of contacts through mailed information was maintained throughout the pregnancy. The findings have implications for strengthening the intervention activities that are presently offered to pregnant smokers.