Olaiya Oluwatosin, Sharma Andrea J, Tong Van T, Dee Deborah, Quinn Celia, Agaku Israel T, Conrey Elizabeth J, Kuiper Nicole M, Satten Glen A
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; U.S. Public Health Service Commissioned Corps, Atlanta, GA, USA.
Prev Med. 2015 Dec;81:438-43. doi: 10.1016/j.ypmed.2015.10.011. Epub 2015 Oct 31.
We assessed whether smoking cessation improved among pregnant smokers who attended Women, Infants and Children (WIC) Supplemental Nutrition Program clinics trained to implement a brief smoking cessation counseling intervention, the 5As: ask, advise, assess, assist, arrange.
In Ohio, staff in 38 WIC clinics were trained to deliver the 5As from 2006 through 2010. Using 2005-2011 Pregnancy Nutrition Surveillance System data, we performed conditional logistic regression, stratified on clinic, to estimate the relationship between women's exposure to the 5As and the odds of self-reported quitting during pregnancy. Reporting bias for quitting was assessed by examining whether differences in infants' birth weight by quit status differed by clinic training status.
Of 71,526 pregnant smokers at WIC enrollment, 23% quit. Odds of quitting were higher among women who attended a clinic after versus before clinic staff was trained (adjusted odds ratio, 1.16; 95% confidence interval, 1.04-1.29). The adjusted mean infant birth weight was, on average, 96 g higher among women who reported quitting (P<0.0001), regardless of clinic training status.
Training all Ohio WIC clinics to deliver the 5As may promote quitting among pregnant smokers, and thus is an important strategy to improve maternal and child health outcomes.
我们评估了在参加妇女、婴儿和儿童（WIC）补充营养计划诊所的孕妇吸烟者中，戒烟情况是否有所改善。这些诊所接受了实施简短戒烟咨询干预措施“5A法”（询问、建议、评估、协助、安排）的培训。
在俄亥俄州，38家WIC诊所的工作人员在2006年至2010年期间接受了“5A法”培训。利用2005 - 2011年妊娠营养监测系统的数据，我们进行了条件逻辑回归分析，并按诊所分层，以估计女性接触“5A法”与孕期自我报告戒烟几率之间的关系。通过检查按戒烟状态划分的婴儿出生体重差异是否因诊所培训状态而异，评估戒烟报告偏差。
在WIC登记的71526名孕妇吸烟者中，23%戒烟。在诊所工作人员接受培训后就诊的女性比培训前就诊的女性戒烟几率更高（调整后的优势比为1.16；95%置信区间为1.04 - 1.29）。无论诊所培训状态如何，报告戒烟的女性所生婴儿的调整后平均出生体重平均高出96克（P<0.0001）。
培训俄亥俄州所有WIC诊所实施“5A法”可能会促进孕妇吸烟者戒烟，因此是改善母婴健康结局的一项重要策略。
