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Although a number of studies have assessed differences in personal and interpersonal factors between smokers and non-smokers (for example, age, smoking during previous pregnancies, partner smoking status), there has been little attention to the social context in which women make decisions about prenatal health behaviours.1 For pregnant women who are poor, undereducated, and facing housing or economic crises, the immediate benefits provided by smoking may outweigh the long term risks of smoking during pregnancy. In order to improve the effectiveness of smoking interventions for pregnant women, it may be necessary to place smoking in the broader social context in which these women live, and integrate it into other programs that address basic life needs.
The Healthy Baby Second-Hand Smoke Study was a pilot program designed to evaluate the role of public health nurses in delivering a novel smoking intervention to limited income, high risk pregnant women. The Healthy Baby Program (HBP) is a social service program that provides medical and social service outreach to low income pregnant women who are at risk for poor birth outcomes because of their medical history or socioeconomic circumstances. A collaboration was formed with the HBP to develop the HBP Second-Hand Smoke intervention, which was designed to motivate pregnant women towards reducing their household exposure to second hand smoke and towards smoking cessation, and to provide skills to those who want to quit smoking. Because of the attention to other life issues provided by the Healthy Baby Program, it was hypothesised that participants might be more able to address smoking as an important health issue.
This study was conducted with clients served by the Healthy Baby Program (HBP). The HBP team includes nurses and advocates who serve Boston neighbourhoods with the highest rates of infant deaths and low birth weight. Nursing services include health …