This presentation focuses on what we know now about the effectiveness of different methods of smoking cessation that have been used for pregnant smokers. Windsor et al published a meta-evaluation of the completed evaluation studies for pregnant smokers.1 This methodological review examined 31 quasi-experimental and experimental studies. It was designed to derive insight about the validity of the different studies, but more importantly, the variety of different patient education methods evaluated. This insight, combined with the Agency for Healthcare Policy and Research Guideline,2 was used to develop the patient education methods for the ongoing National Institutes of Health funded SCRIPT project: “Smoking Cessation or Reduction in Pregnancy Trial”.

A meta-analysis of the literature confirmed that self help methods delivered by trained staff were the most effective methods. Information is presented in table 1 on this meta-analysis. This information is included in a publication presenting the results of SCRIPT.3

The purpose of SCRIPT is to evaluate the effectiveness of evidence based methods, delivered by trained, regular prenatal care staff who provide services to Medicaid patients. The data in table 2confirm that the brief counselling methods, combined with a tailored video, were significantly more effective than the normal informational methods with Medicaid patients. These data are derived from patients entering care at 10 sites throughout the state of Alabama. The intervention methods are delivered routinely to the experimental patients by social workers, nurses, and women, infant, and children nutritionists. All rates are cotinine confirmed, with a baseline for each patient and a follow up for each patient in the third trimester and postpartum.