Evaluation of a motivational smoking cessation intervention for women in public health clinics

Background. A multicomponent motivational smoking cessation intervention was evaluated in 33 prenatal, family planning, and pediatric services in 12 public health clinics. Clinic-based intervention components were implemented by clinic personnel as part of routine medical visits. Methods. The evaluation design included pre- and postintervention measurements of multiple study outcomes in a baseline (all clinics prior to the start of the intervention) and an experimental period (matched-pair random assignment of clinics to intervention or control conditions). Subjects were 683 (baseline) and 1,064 (experimental) smokers with measurements of smoking outcomes at both times, Mixed-effects regressions analyzed individual outcomes clustered within clinics and services. Results. Control and intervention clinics had similar outcomes in the baseline period. In the experiment, outcomes improved in the intervention but not in the control clinics. Compared to controls, smokers exposed to the intervention were more likely to have quit (14.5 versus 7.7%) or take actions toward quitting and had higher mean action, stage of readiness, and motivation to quit scores. These positive effects persisted when clustering within clinics and services was controlled. Conclusions. This intervention, implemented by clinic personnel as part of routine medical visits, was effective under these natural conditions across different types of clinic service, (C) 1999 American Health Foundation and Academic Press.