Intervention type

Physician or nurse adviceIndividual or group-based counselingTelephone and mobile phone–based interventionsPsychosocial intervention in pregnant persons
Intervention recipientAdult smokers motivated to quitAdult smokers, regardless of motivation to quit
  • Adult smokers motivated to quit

  • Most mobile phone–based interventions targeted adults younger than 45 years

Pregnant smokers
Behavior change goals and techniquesSpecific advice varied but generally included a verbal stop smoking message
Most often, advice was given along with print materials, additional advice from health care staff, or a referral to a cessation clinic
Typically included review of smoking history and motivation to quit, help in the identification of high-risk situations and the generation for problem solving strategies, and nonspecific support and encouragement
Many group-based sessions included cognitive behavioral therapy. Initial sessions focused on discussion of motivation for quitting, health benefits, and strategies for planning a quit attempt
Telephone counseling and mobile phone–based interventions were generally tailored to participants' smoking history and readiness to quit and focused on increasing motivation and likelihood of quittingCognitive behavioral, motivational, and supportive therapies that include counseling, health education, feedback, financial incentives, and social support
Intervention intensityOften a single session lasting less than 20 minutes (with or without print materials) plus up to 1 follow-up visit between 1 week and 3 months laterOften 1 face-to-face session with follow-up over 1 week to 4 months later
Individual-based counseling given during 1 face-to-face session with multiple follow-up sessions in person or via telephone
Group-based counseling delivered over 6 to 8 sessions
Varied from 2 weeks to 1 year, with most taking place over 3 to 4 months
Telephone counseling:
 1 to 12 calls
 10 to 20 minutes per call, although the first calls were often longer
Occurred during scheduled telephone calls that began after smokers had first called a smoking quit line
Mobile phone–based:
 Fewer than 2 messages per day every day over the course of the intervention
 Used text messaging
Recruited during first prenatal visit or during second-trimester visit and continued through late pregnancy
Frequency and intensity varied. Counseling ranged from a single session < 5 minutes to several sessions up to 4 hours per session and has been increasing over time
InterventionistPhysicians (e.g., general practitioners, family practice) or nursing staffSmoking cessation specialists, often with backgrounds in social work, psychology, psychiatry, health education, and nursingTelephone counseling provided by professional counselors or trained health care professionals
Text messages were developed and administered through computer expert–generated systems
Varied
Practice settingsPrimary care or hospital settingsHospital or smoking cessation clinic settingsVirtual via telephone or mobile phone; a few studies provided face-to-face supportWomen's health clinic or smoking cessation clinic
Examples of interventions and materials used in studies,Intervention: Morgan, et al.,15 1996
Material used: Clear Horizons: A Quit Smoking Guide Especially for Those 50 and Over (Orleans, et al.,16 1989)
Intervention: Canga, et al.,17 2000
Materials used: Based on How to Help Your Patients Stop Smoking: A National Cancer Institute Manual for Physicians18 and the orientation of the Mayo Nicotine Dependence Center19
Intervention: Weissfeld, et al.,20 1991
Material used: Clearing the Air: How to Quit Smoking and Quit for Keeps (National Cancer Institute,21 1987)
Other interventions:
 Fiore, et al.,22 2004
 Glasgow, et al.,23 2000
Intervention: Bock, et al.,24 2013
Material used: American Lung Association guide (Strecher, et al.,25 1989)
Intervention: Orleans, et al.,26 1991
Material used: A Lifetime of Freedom from Smoking (American Lung Association,27 1980)
Intervention: McBride, et al.,28 1999
Material used: Clearing The Air: Quit Smoking Today (National Cancer Institute, 2008 [https://www.cancer.gov/publications/patient-education/clearing-the-air])
Other interventions: Curry, et al.,29 1995; Ellerbeck, et al.,30 2009; McClure, et al.,31 2005
Intervention: Rigotti, et al.,32 2006
Material used: Solomon and Quinn,33 2004
Intervention: Windsor, et al.,34 2011
Materials used: Ask-Advise-Assess-Arrange SCRIPT,12,3537 including a video,38 guide to quit smoking,39 and a ≤ 10-minute counseling session40
Other interventions: Bullock, et al.,41 2009; Lee, et al.,42 2015; Pollak, et al.,43 2013; Stotts, et al.,44 2009
Demonstrated benefit§Increases the rate of smoking cessation at 6 months or more
Physician advice: 1.76 (95% CI, 1.58 to 1.96). Some evidence suggests that providing additional follow-up is more effective
Nurse advice: 1.29 (95% CI, 1.21 to 1.38)
Increases the rate of smoking cessation at 6 months or more
Individual counseling: RR, 1.48 (95% CI, 1.34 to 1.64)
Group-based therapy: RR, 1.88 (95% CI, 1.52 to 2.33)
Increases the rate of smoking cessation at 6 months or more
Telephone counseling (provided after smoker calls quit line): RR, 1.38 (95% CI, 1.19 to 1.61)
Telephone counseling (other settings): RR, 1.25 (95% CI, 1.15 to 1.35)
Mobile phone–based interventions: RR, 1.54 (95% CI, 1.19 to 2.00)
Some evidence that interventions were more effective for smokers who were motivated to quit
Increases smoking cessation in late pregnancy: RR, 1.35 (95% CI, 1.23 to 1.48)
Interventions more effective when counseling was more intensive, augmented with messages and self-help materials tailored for pregnant women, and included messages about the effects of smoking on both maternal and fetal health with strong advice to quit as soon as possible
Health education, without counseling, was not effective