Objective: To evaluate two nursing approaches to promoting smoking cessation during initial antenatal visits.
Design: Experimental, with assignment to interventions using a random, alternate-day strategy and blind assessment of smoking at baseline, 1 month postintervention, 36 weeks' gestation, and 6 weeks postpartum.
Setting/participants: 224 daily smokers, fewer than 31 weeks gestation, during first prenatal visit, at a teaching hospital antenatal clinic.
Interventions: An evening class providing guidance on a self-help program for 2 hours on a group basis or 20 minutes on an individual basis during the prenatal appointment.
Main outcome measure: Smoking cessation, confirmed by urinary cotinine levels.
Results: All women assigned to the referral intervention received a referral, but none attended the classes. In contrast, 93% assigned to the immediate intervention received the intervention. The group receiving immediate intervention had two to three times higher rates of cessation at all follow-up periods, with significant differences at the 1-month follow-up. There were certain similarities between the groups.
Conclusion: Cessation interventions should be administered during the first prenatal visit.