"Cigarette smoking causes a lot of problems for mother and baby, and we need to find ways to encourage women to remain nonsmokers after the baby is born," McBride said.
Besides cigarettes' link to diseases like lung cancer and emphysema, there are known risks during pregnancy. Pregnant smokers are more likely to have low birth weight babies and complications during birth. Their babies are at higher risk for Sudden Infant Death Syndrome, and nicotine is passed to the baby in breast milk. Young children exposed to second-hand smoke have more upper respiratory infections.
"Some of these women have been non-smokers for seven to 10 months," McBride said. "Other groups of smokers who stay off cigarettes for 10 months are home free, but that's not true for pregnant women.
"We've been able to delay relapse in this study, but we need to do more," she said. "We need to build this type of support intervention into the women's social networks."
One of the major predictors of relapse is living with another smoker, so McBride is enlisting women's partners for help in a new study based at Ft. Bragg. She hopes this intervention will both prevent partners from smoking and give cessation support that will stick around. The final results are expected in a few years.
"Our first study relied on telephone counseling by a trained health educator, but someone the women didn't know. When that went away, the smoking came back," she said. "Partners have an equal investment in the child and could be a source of ongoing support."
Additionally, she said, it might be possible to train pediatricians to help prevent relapse through contact at well-baby visits.