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During a 3-month recruitment period, a smoking cessation program was provided to all pregnant women who attended an HMO prenatal clinic and reported either that they were currently smokers (n = 35) or that they had quit at pregnancy onset (n = 23). Except for its in-clinic introduction, the behavioral smoking cessation program used a home-correspondence format with seven weekly mailings and a telephone answering system adjunct. At follow-up, all 23 women who identified themselves at baseline as self-initiated quitters reported continued abstinence from smoking. Urine thiocyanate assays confirmed these self-report data in 82% of the cases. Results of a multivariate analysis identified three factors--gravida, number of years a smoker, and number of friends who smoke--as significant predictors of self-initiated quitting. Of the 35 women who indicated that they were still smoking at baseline, 10 (28.5%) reported that they had stopped smoking at the time of the postprogram assessment. Available urine thiocyanate assays confirmed a nonsmoking status in all cases. The multivariate results indicated that four variables--gravida, severe nausea, baseline smoking rate, and spouse's smoking status--were significant predictors of quitting following exposure to the program. The majority of both self-initiated quitters and postprogram quitters reported that the program was useful in helping them to quit smoking and/or to remain abstinent over time. These results lend support to the viability of a home-correspondence, self-help program as a means for facilitating smoking cessation and continued abstinence from smoking during pregnancy.

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This report describes the 1-year follow-up assessment of a television-based smoking cessation program shown as a part of local news in the Los Angeles area. The post-broadcast experiences of two distinct samples was considered: individuals who wrote in for additional materials (Registrants) and a cross section sample (CS) contacted by a random survey method. Results showed significant between-group differences in demographic characteristics and smoking behavior outcomes. Compared to the CS sample, registrants displayed more quitting attempts during the 1-year follow-up period (70.7% and 49.8%) and more abstinence (6.2% and 2.4%, respectively). When compared to results from a comparison survey, both registrant and CS subjects made significantly more quitting attempts in the three week period following broadcast. In terms of abstinence, only registrant results significantly differed from the comparison survey (6.2% vs. 2.9%). Few correlates of outcome were identified. Overall, analyses suggest that the televised quit smoking program encouraged viewers to initiate more numerous attempts to quit smoking than otherwise would have been expected. In terms of maintaining nonsmoking over time, however, only registrants experienced significantly greater success than might have been observed in the general population. Implications for research and policy recommendations of televised health promotion programs are proposed.

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This report presents the results of an evaluation of a prenatal health education program conducted within a health maintenance organization (HMO) setting. Specifically, the behavioral, birth, and treatment-cost outcomes for 57 women in an experimental group who received individual nutrition counseling and a home-correspondence smoking cessation program were evaluated against the outcomes for 72 women in a control group who received standard prenatal care. In comparison with the controls, a greater percentage of women in the experimental group quit smoking during pregnancy (49.1 percent versus 37.5 percent). Of those who smoked throughout their pregnancy, women in the experimental group had a greater reduction in their mean rate of daily smoking. A significantly greater percentage of experimental group women adjusted their diets during the prenatal period (91 percent versus 68 percent), and particular success was achieved in increased consumption of dairy products and vegetables, decreased consumption of coffee, and adequate weight gain during pregnancy. Analysis of birth outcome data revealed that infants born to the experimental group had a significantly higher mean birth weight than infants born to the controls (121.34 oz versus 113.64 oz). The experimental group also had fewer low birth weight infants (7.0 percent versus 9.7 percent for controls). Hospital treatment cost savings associated with the reduced incidence of low birth weight infants among experimental group women yielded an overall benefit-cost ratio for the prenatal program of approximately 2:1.

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Smoking cessation programming is appearing with increasing frequency over the medium of television. This report reviews those television quit smoking programs that have been described in the literature. Programming features (e.g., program timing, content, utilization, and cost-effectiveness) are examined in addition to the assessment of the impact on viewers' smoking behavior. Overall, published reports have described a host of intriguing ways the TV medium can be used to encourage widespread smoking cessation. To date, however, there has been relatively less innovation and thoroughness in terms of assessing program impact. Implications are discussed for the burgeoning realm of health promotion programming via the electronic media.

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Forty smokers and 47 overweight individuals were recruited for a home correspondence program for either smoking cessation or weight loss. Participants were assigned to one of four programs for changing their respective health behaviors: (1) a home correspondence program conducted entirely by mail, (2) the mail program with supplemental financial contigency contracts tied to completion of written homework, (3) the correspondence programs supplemented both by homework contracts and by regular calls to a telephone answering system, and (4) a standard behavioral group program which acted as a comparison condition. Results showed that all three correspondence approaches produced significant changes in health behaviors equal to the changes experienced by participants in the standard group program. The implication of these findings for development of low cost programs for disease prevention are discussed.

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The smoking cessation component of a residential program which attempts to concurrently intervene on several risk factors related to chronic disease is described. Seventy-two per cent of the 43 smokers in the first 13 cohorts were abstinent at discharge. Fifty-five per cent were abstinent at two months. Six-month data for the first nine cohorts show 53 per cent abstinence. Possible advantages and disadvantages of a multiple behavior change program in a residential setting are discussed.

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Tenth grade health classes in three high schools received a special program focusing on the immediate physiological effects of cigarette smoking and the social cues influencing adoption of the smoking habit, and classes in two control schools received standard information on the long-term effects of smoking. Only subjects in the special program reported a decrease in smoking from pre to post-test; they also scored higher than controls on a knowledge test. Carbon monoxide levels were significantly lower for subjects in the special group at post-test.

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For reasons of health and economics, the business community is displaying a growing interest in providing smoking cessation programs for employees. An examination of the current research on smoking cessation methods has revealed a number of promising directions that smoking cessation programs can take, for example, aversive smoking approaches combined with self-control strategies. A review of current smoking cessation programs in occupational settings revealed some emphasis on physician counseling, but a relatively greater emphasis on use of consultants (especially in proprietary programs) or of contingency programs to encourage nonsmoking.The smoking cessation programs in businesses can move in a number of innovative directions, including (a) increased use of inhouse programs with a variety of smoking cessation strategies; (b) greater emphasis on the training of program participants in nonsmoking behavioral skills, combined with contingency or incentive programs for smoking control; (c) vastly improved research methods, including complete followup assessments of program participants and chemical tests to validate their self-reported abstinence; (d) greater concern about the need for empirically tested procedures for recruitment of participants for the programs; and (e) expanded interchange among behavioral scientists (especially behavioral psychologists), health professionals in occupational health and medicine, union and employee groups, and management.

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