Smoking Cessation Intervention for Pregnant Patients

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ASK - 1 minute
  • Ask the patient to choose the statement that best describes her smoking status:
A. I have NEVER smoked or have smoked LESS THAN 100 cigarettes in my lifetime.
B. I stopped smoking BEFORE I found out I was pregnant, and I am not smoking now.
C. I stopped smoking AFTER I found out I was pregnant, and I am not smoking now.
D. I smoke some now, but I have cut down on the number of cigarettes I smoke SINCE I found out I was pregnant.
E. I smoke regularly now, about the same as BEFORE I found out I was pregnant.

If the patient stopped smoking before or after she found out she was
pregnant (B or C), reinforce her decision to quit, congratulate her on
success in quitting, and encourage her to stay smoke free throughout
pregnancy and postpartum.

If the patient is still smoking (D or E), document smoking status in her
medical record, and proceed to Advise, Assess, Assist, and Arrange.

ADVISE - 1 minute

  • Provide clear, strong advice to quit with personalized messages about the benefits of quitting and the impact of smoking and quitting on the woman and fetus.

ASSESS - 1 minute

  • Assess the willingness of the patient to attempt to quit within 30 days.

If the patient is ready to quit, proceed to Assist.

If the patient is not ready, provide information to motivate the patient to
quit and proceed to Arrange.

ASSIST - 3 minutes +

  • Suggest and encourage the use of problem-solving methods and skills for smoking cessation (e.g., identify “trigger” situations).
  • Provide social support as part of the treatment (e.g., “we can help you quit”).
  • Arrange social support in the smoker’s environment (e.g., identify “quit buddy” and smoke-free space).
  • Provide pregnancy-specific, self-help smoking cessation materials.

ARRANGE - 1 minute +

  • Assess smoking status at subsequent prenatal visits and, if patient continues to smoke, encourage cessation.


Smoking Cessation During Pregnancy. ACOG Educational Bulletin, Number 260, September, 2000.

Data from Melvin, C., Dolan Mullen, P., Windsor, R.A., Whiteside, H.P., Goldenberg, R.L. Recommended cessation counseling for pregnant women who smoke: A review of the evidence. Tobacco Control 2000; 9:1-5.

Additional clinical tools are available from the Agency for Healthcare Research and Quality (AHRQ) at: (800) 358-9295 or

For more information or additional cards, contact:

Minnesota Department of Health
P.O. Box 64975
St. Paul, MN 55164-0882
651-201-3760 PHONE
651-201-5137 TDD/TTY

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