Perinatal attentional retraining intervention for smoking – A pilot study

Aims: Almost half of women who smoke prior to pregnancy achieveabstinenceduringpregnancy, butnearly50%relapsewithin 2 weeks of delivery. Despite considerable study, there are few strategies that effectively combat smoking relapse in this population. Thus, we tested a novel technique: the use of smart-phones to administer attentional retraining (AR) as an ecological momentary assessment intervention for relapse prevention in postpartum women. We hypothesized that relative to control, women randomized to AR would show less attentional bias (AB) toward smoking-related stimuli, and a decrease in craving. Methods:Women (N=11)were recruitedduringpregnancyand carried a smart-phone as they went about their daily lives for 1–2 weeks in the lastmonthofpregnancyand immediatelypostpartum. Participants were randomized to receive AR (N=6) or attentional control (N=5). The smartphone randomly alerted participants (4 times/day) to respond to questions assessing subjective states, followed by AR (or control) procedures utilizing a visual probe task. Outcomemeasures included attentional bias for smoking and craving. Results: Participants carried a smartphone for a mean of 20.2 days, completed 444 assessments (60.14% pregnancy; 39.86% postpartum) and 2.92 assessments per day. Craving increased from pregnancy (M=1.40, SD=1.23) to postpartum (M=2.28, SD=2.27); postpartum participants reported having smoked since the last assessment on 12.64% of assessments, and 8 women reported smoking at least 1 cigarette during the study. AB was more negative in theAR group (n=35 assessments,M=−52.6ms, SD=122) vs. controls (n=44 assessments, M=18.5ms, SD=146) (p