Elsevier

Fertility and Sterility

Volume 74, Issue 3, September 2000, Pages 498-503
Fertility and Sterility

Infertility
Randomized trial of a “stage-of-change” oriented smoking cessation intervention in infertile and pregnant women

Presented at the conjoint meeting of the American Society for Reproductive Medicine and the Canadian Andrology and Fertility Society, Toronto, Ontario, Canada, 1999. Prize paper, best oral presentation (clinical).
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Abstract

Objective: To assess a “stage-of-change” oriented smoking cessation intervention for infertile and pregnant women, compared with standard of care.

Design: Randomized controlled trial.

Setting: Three university teaching hospitals in Hamilton, Ontario, Canada.

Patient(s): Infertile women at their first visit to a tertiary referral infertility clinic (n = 94) and new patients seeking pre-natal care (n = 110) who had smoked ≥ 3 cigarettes in the past six months.

Intervention(s): A three to five minute scripted intervention and booklet specific to the woman’s “stage-of-change” in the smoking continuum, versus standard of care. Exhaled carbon-monoxide (CO) monitoring was used to validate exposure in both groups.

Main Outcome Measure(s): Delta “stage-of-change” and rate of maintained cessation at 12 months post follow-up.

Result(s): Intervention and control were similarly effective for infertile women: the rate of maintained cessation rose significantly from 4% to 24% over twelve months, with a mean delta “stage-of-change” 0.28. In prenatal women, neither approach was effective. Maintained cessation did not significantly change from 0 to 12 months (19% to 18%). Mean delta “stage-of-change” declined by −0.62.

Conclusion(s): For infertile women, basic information describing the impact of smoking on fertility, along with exhaled CO monitoring and a more intensive intervention were both highly effective. In pregnant women neither approach was beneficial, with some evidence of post-partum relapse.

Keywords

Smoking cessation
intervention
infertility
pregnancy
stage of change

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Supported by the Father Sean O’Sullivan Foundation, the Hamilton Health Science Foundation, Ron Herkimer and Susan Sakowski, and the Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.