CLINICAL REVIEW Smoking Cessation in Pregnancy: A Review of Postpartum Relapse Prevention Strategies

on smoking cessation relapse and relapse prevention in pregnancy and postpartum. Methods: A MEDLINE/PubMed search in 2002 and 2003 for articles containing the key words “smok-ing, ” “pregnancy, ” “cessation, ” and “cessation relapse prevention ” and references of retrieved papers yielded a review of more than 500 articles. Only 14 of these addressed program-based strategies to in-crease cessation among pregnant women through relapse prevention programs. Conclusion: Although there is much information on the rationale and strategies for smoking cessa-tion for pregnant women, fewer studies exist on how to prevent relapse. Maintaining and accelerating progress in cessation during pregnancy and postpartum requires more research that focuses on relapse prevention and cessation. Programs should incorporate stresses particular to postpartum women, should be part of routine health care, and should involve the woman’s social support network, includ-ing her partner, to maximize effectiveness. (J Am Board Fam Pract 2004;17:264–75.) Throughout the past decade, tobacco use has re-mained the single most important modifiable cause of poor pregnancy outcome in the United States. Smoking accounts for 20 % of deliveries of infant