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Aim: To test the efficacy of an aid to cessation/relapse prevention intervention for women postpartum., Method: Two-armed randomized controlled trial. Follow-ups at 6, 12, 18, and 24 months, screenings on maternity wards. Intervention group received face-to-face counseling 40 days postpartum plus telephone counseling calls 4 and 12 weeks later. Control group received usual care plus self-help material for each parent., Results: With regard to smoking cessation, 4 week point prevalence abstinent rates were higher in the treatment group at 6, 12, and 18 months (7% vs. 1%, 7% vs. 2%, and 9% vs. 1%, respectively). Sustained abstinence was higher in the treatment group at 6 months follow-up (3% vs. 0%). No difference was observed with regard to relapse prevention., Discussion: Regarding aid to cessation we observed small effects, regarding relapse prevention no effect. In order to capitalize on the opportunity childbirth poses with regard to smoking, theories on relapse prevention in smoking cessation that guide in designing interventions are needed.

Objectives: 1. Quantitative description of the adherence to the principles of Motivational Interviewing (MI) in smoking counseling sessions, 2. Examination of the relation between clients' characteristics and the adherence to the principles of MI, and between adherence to the principles of MI and future smoking status., Methods: A sample of n=163 sessions conducted during a randomized controlled trial in testing the effectiveness of a population-based smoking intervention in women postpartum was investigated. Demographic and behavior-related variables were included in a logistic regression to predict adherence to MI. Adherence was measured using the Motivational Interviewing Treatment Integrity (MITI) scale., Results: Of the sessions, 49.4% showed good adherence to MI. The OR of receiving a good MI session was 3.1 for non-smokers in comparison to daily smokers. No other demographic or behavioral variable gained statistical significance. The relation between adherence and intervention outcome after 6 months was statistically significant (chi(2)=6.459, p<0.05)., Conclusions: This intervention study shows a satisfactory degree of adherence to and the effectiveness of MI. MI-adherence seems more likely in sessions concerned with smoking relapse prevention compared to smoking cessation sessions.

Objective: (a) To describe a population-based sample of women postpartum who smoked before pregnancy on grounds of the perceived advantages and disadvantages of nonsmoking and the self-efficacy not to smoke. (b) To identify grouping characteristics that can differentiate among those women. This could lead to the development of intervention strategies that are of different efficacy depending on the cluster the woman is member of., Sample: A population-based sample of 317 women who had smoked at the beginning of pregnancy and who were smoke-free at the time of giving birth., Data: Data about the acquisition stages of change to restart smoking, the perceived advantages of nonsmoking and the self-efficacy to remain smoke free on grounds of the Transtheoretical Model of Behavior Change was assessed. Smoking status was assessed 12 months later., Statistical Analysis: A cluster analysis was used to identify different groups; a logistic regression was calculated to assure the external validity of the clusters identified., Results: The acquisition stages of change do not fit the situation of nonsmoking women postpartum in Germany, but four different clusters of ex-smoking women postpartum were identified on grounds of the other TTM-constructs. These are: the protected, the high risk, the premature and the ambivalent group. The clusters are associated with relapse after 12 months, none of the other variables controlled for was statistically significant., Conclusions: The TTM contributes to a better understanding of nonsmoking women postpartum. Further studies have to replicate the clusters found and have to find whether interventions tailored to these clusters are more effective in preventing relapse than other interventions.