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Smoking cessation programs that have been used during pregnancy include brochures, physician advice, and counselling. Standardised self help brochures alone have minimal impact1; tailored messages are more effective.2 Face to face counselling requires training and is time consuming in a busy clinic. Multimedia (non-text based) approaches can reach populations with low literacy levels. Interactive digital media also allows users to learn by making choices and then noting the consequences of their actions. Health messages can be tailored to the user in real time. We designed a digital, interactive smoking cessation intervention tailored for pregnant women and tested it in public health clinics.
The study population consisted of pregnant smokers enrolled in the Douglas County (Omaha), Nebraska Women, Infants and Children (WIC) program. The mission of the WIC program is to decrease the number of low birth weight babies born to low income or otherwise at risk women. At the time the study was initiated, the most recent 12 month data available from the Centers for Disease Control (CDC) Pregnancy Nutrition Surveillance program was from 1992. These data indicated that 31.9% of Douglas County WIC participants smoked during pregnancy. Pregnant women who were current smokers (defined as a client who “self reported smoking at least one puff of a cigarette in the last seven days”) were eligible for study participation. Informed consent was obtained following guidelines of the Creighton University institutional review board. Women received vouchers from WIC on a monthly basis and this provided an opportunity for us to collect data. Incentives ($10 vouchers for merchandise at a local store—marked “not for alcohol or tobacco”) were given to participants at the completion of each study …