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Smoking and Cellular Telephone Use Among Pregnant Women Seeking Prenatal Care: Opportunities for Intervention

Gilbert, Jennifer BA*; Schnoll, Robert PhD*; Morrison, Mary F. MD; Srinivas, Sindhu K. MD, MSCE; Pond, Timothy MPH*; Curtis, Brenda PhD§; Henry, Jennifer MA; Kranzler, Henry R. MD*,∥

Addictive Disorders & Their Treatment: December 2015 - Volume 14 - Issue 4 - p 203–210
doi: 10.1097/ADT.0000000000000053
Original Articles

Objectives: Although smoking during pregnancy is associated with poor pregnancy outcomes, many women continue to smoke throughout pregnancy. Behavioral interventions for smoking cessation yield modest benefits, particularly in lower socioeconomic groups. Pharmacotherapy, a first-line option for smoking cessation, has not shown clear benefits for pregnant smokers, partly due to limited adherence. We evaluated the feasibility of conducting a pharmacotherapy trial for smoking cessation in pregnant women, using text messaging to enhance medication adherence.

Materials and Methods: We surveyed 724 predominantly minority pregnant women to examine the prevalence and correlates of smoking and the use of cellular telephones and text messaging.

Results: Nearly 18% of the respondents were current smokers, with a majority (67.7%) expressing interest in participating in a smoking cessation trial. Only about 6% of women with a smoking history ever received nicotine dependence treatment. Smokers were significantly more likely to be depressed than nonsmokers. The vast majority of respondents (92.1%) owned cell phones, with 93.2% having an unlimited text messaging plan.

Conclusions: These data support the feasibility of conducting a pharmacotherapy smoking cessation trial and using text messaging to enhance medication adherence in a predominantly minority population of pregnant smokers.

*Department of Psychiatry, Perelman School of Medicine

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Perelman School of Medicine, University of Pennsylvania

Department of Psychiatry, Temple University School of Medicine

§Treatment Research Institute

Philadelphia VAMC, Philadelphia, PA

Supported, in part, by a Grant from the National Institute on Alcohol Abuse and Alcoholism (K24 AA13736 to HRK).

H.R.K. has been a consultant or advisory board member for Alkermes, Lilly, Lundbeck, Pfizer, and Roche. He is also a member of the American Society of Clinical Psychopharmacology’s Alcohol Clinical Trials Initiative, which is supported by Lilly, Lundbeck, AbbVie, and Pfizer. R.S. is a consultant for and has received study medication from GlaxoSmithKline and Pfizer. M.F.M. has received research support from Astra Zeneca. The remaining authors declare no conflict of interest.

Reprints: Henry R. Kranzler, MD, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3900 Chestnut St., Philadelphia, PA 19104 (e-mail:

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