PRINCETON, N.J., Sept. 13 (AScribe News) -- A brief cessation counseling program, which takes five to fifteen minutes of a health care provider's time with a pregnant woman, can result in 30 percent reduction of smoking, according to a study published in

``Smoking cessation is one of the most important actions a woman can take to improve the outcome of her pregnancy. Despite the acknowledged harm associated with tobacco use during pregnancy for both mother and infant, a large proportion of pregnant women continue to smoke,'' said study author, Cathy L. Melvin, Ph.D., who runs the Smoke-Free Families National Dissemination Office at the University of North Carolina - Chapel Hill. The Robert Wood Johnson Foundation recently awarded the Cecil G. Sheps Center for Health Services Research at UNC a one-year, $1.2 million grant to establish the National Dissemination Office of the Smoke-Free Families Program. According to Melvin, about 20 percent of women smoke throughout their pregnancy. ``We are excited about this low-intensity intervention which achieves a modest, but clinically significant effect on cessation rates.'' The pregnancy-specific intervention, which incorporates five steps, can achieve at least a 30 percent higher rate of reduction in smoking than other methods. The steps are: - Ask: Health care providers should ask about tobacco use as part of the information intake process. Many pregnant women are reluctant to disclose their smoking status at their first prenatal visit. Deception rates as high as 23 percent among Medicaid insured and about 14 percent of privately insured pregnant women have been confirmed. The study indicates that non-disclosure can be reduced using a simple multiple-choice question either in a written or oral information intake system. - Advise: For women who smoke, health care professionals can provide clear and strong advice to quit, with personalized messages about the impact of smoking and quitting. - Assess: The willingness of the woman to make a quit attempt within the next 30 days should be assessed. - Assist: For women who want to attempt to quit, pregnancy-specific self-help materials are available. Health care providers can also suggest and encourage the use of problem solving methods and skills, arrange social support in the smoker's environment; and provide social support as a part of the treatment. - Arrange: Periodically health care providers should assess the patient regarding smoking status. If she is a continuing smoker, cessation should continue to be encouraged. According to C. Tracy Orleans, Ph.D., Senior Scientist at The Robert Wood Johnson Foundation, ``We know health care providers want to help their pregnant patients quit smoking. And we know that most pregnant smokers want to quit and need their help. These guidelines will give physicians, nurses and many other prenatal care providers better tools to diagnose and treat tobacco dependence.'' ``The Foundation is committed to innovative strategies to apply and extend guidelines to reduce tobacco use in three critical populations: (1) pregnant smokers; (2) smokers enrolled in managed health care programs; and (3) adolescent and young adult (12-24) smokers,'' said Orleans. The Tobacco Control supplement includes additional original articles, project briefs and technical reports about the Smoke-Free Families initiatives. The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation's largest philanthropy devoted exclusively to health and health care. It concentrates its grant making in three goal areas: to assure that all Americans have access to basic health care at reasonable cost; to improve care and support for people with chronic health conditions; and to reduce the personal, social and economic harm caused by substance abuse -- tobacco, alcohol, and illicit drugs.

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