Smoking cessation in an OB/GYN residency clinic

The objective of this study was to evaluate changes in the behaviors of pregnant women who smoke and their care providers following implementation of a comprehensive multidisciplinary smoking cessation program. A retrospective cohort study of 202 charts before and after program implementation was conducted. We examined patients' self-reported smoking behaviors and documentation of care providers' responses over the course of prenatal care. Chi-square analyses and Student's t-tests were used as appropriate with significance at p < 0.05. Overall smoking rates were 41% and 44% during the two time intervals. Significant reductions in daily cigarette consumption were found following implementation of the program (37% vs. 71%). No significant increase in smoking cessation was observed (29% vs. 32%). A significant difference in the time interval between initial identification of smoking during pregnancy and documentation of intervention was found (11.56 ± 7.14 vs. 7.65 ± 6.06 weeks). The percentage of pregnant smokers in the clinic was 2.5 times the statewide rate and 3.5 times the national rate. While cessation is the ideal goal, reductions in daily cigarette consumption contribute to reduced risk of low birth weight babies. The majority of the patients accomplished this goal. Changes in care provider behavior were limited to cessation counseling earlier in the course of prenatal care. Suggestions for program improvements include additional structure and increased training.