Approximately 40% of women who smoke tobacco quit smoking during pregnancy, yet up to 85% relapse after delivery. The risks to mom and baby are well known, both during the pregnancy and through second hand smoke afterwards. The implementation of monthly counseling sessions and the incentive of a free case of diapers can drastically reduce the relapse rates.

Proposed change:

Introduce programs that offer incentives to participants that make healthy lifestyle choices.

Implementation, outcomes and evaluation:

150 pregnant women who were everyday smokers. Cessation program was offered to all smokers during their prenatal care in three counties in western Pennsylvania.  Participants were self-selected. Participants were enrolled in the Healthy Living: Keeping Me Smoke Free program. 3-6 prenatal counseling sessions were offered. Monthly counseling sessions, CO2 monitoring and distribution of diapers were scheduled during the 12 months following delivery. 

Implications for nursing practice:

The use of an incentive such as a case of diapers has shown to decrease the relapse rate to 47% in the 12 month post-partum time frame. The use of an incentive can drastically reduce the post-partum smoking relapse rate of women during the first year. In addition, as the sample population was self-selected, bias may be pervasive. Further research is warranted to see if the findings of this study are generalizable to a population of identified smokers that are not self-identified. With budget issues in the forefront, often times incentives can take various forms; such as diapers, baby goods, or other staple items. Further research is warranted to reveal alternative incentives that are appealing to both mother/babies and management.

Keywords: smoking, cessation, pregnancy, incentives, diapers, relapse