{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:16:16Z","timestamp":1784873776896,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T00:00:00Z","timestamp":1426550400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>West Virginia has the highest rate of prenatal smoking in the United States. The aim of this pilot study was to evaluate the implementation of the American College of Obstetricians and Gynecologists' 5 A's smoking cessation intervention among pregnant women being cared for by 5 A's\u2010trained midwives working with a team of nurse researchers in an effort to reduce prenatal smoking exposure. The evidence\u2010based 5 A's smoking cessation program has been recommended for use in prenatal care by health care providers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A pilot study was conducted evaluating the implementation of the 5 A's prenatal smoking cessation program for 35 women who smoked during pregnancy. The women received consistent messages to quit or reduce smoking from the midwives and were followed by the nurse research team via telephone with continued support, guidance, and strategic planning for tobacco exposure reduction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 35 women who enrolled in the study, 32 (91.4%) decreased smoking and 3 (8.6%) quit smoking by one month after the intervention. For those who continued to smoke, the average number of cigarettes smoked was reduced from 10 cigarettes per day at baseline to 8 cigarettes per day at one month, 7 cigarettes per day at 2 months, and 6 cigarettes per day by the end of pregnancy. The women further reduced their tobacco exposure by delaying the timing of initiating smoking in the morning and by increasing indoor smoking restrictions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Midwives and nurses can be trained in the implementation of the evidence\u2010based 5 A's smoking cessation program for incorporation into regular prenatal care of pregnant women who smoke. By guiding women in techniques aimed at reducing the amount and frequency of cigarette smoking, nurses and midwives facilitate a decrease in prenatal smoking exposure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jmwh.12220","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T17:51:49Z","timestamp":1426614709000},"page":"175-181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Evaluation of a Midwife\u2010 and Nurse\u2010Delivered 5 A's Prenatal Smoking Cessation Program"],"prefix":"10.1111","volume":"60","author":[{"given":"Ilana R. Azulay","family":"Chertok","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey Haynes","family":"Archer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,3,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2007.07.016"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(02)00574-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2006.15.400"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200510000-00052"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1027319517405"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-006-0150-7"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.22891"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-010-0582-y"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm014"},{"key":"e_1_2_9_11_1","first-page":"CD001055","article-title":"Interventions for promoting smoking cessation during pregnancy","volume":"3","author":"Lumley J","year":"2009","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.S1.1176"},{"issue":"6","key":"e_1_2_9_13_1","first-page":"1","article-title":"Trends in smoking before, during, and after pregnancy\u2010 Pregnancy Risk Assessment Monitoring System, United States, 40 sites, 2000\u20132010","volume":"62","author":"Tong VT","year":"2013","journal-title":"MMWR."},{"key":"e_1_2_9_14_1","first-page":"911","article-title":"Smoking during pregnancy \u2013 United States, 1990\u20132002","volume":"53","author":"Centers for Disease Control and Prevention (CDC)","year":"2004","journal-title":"MMWR."},{"key":"e_1_2_9_15_1","unstructured":"West Virginia Department of Health and Human Resources (WV DHHR).Table 21: Pregnancy risk factors cesarean sections delivery complications congenital anomalies and\/or abnormal conditions of the newborn percent by county of residence West Virginia resident births 2006.http:\/\/www.wvdhhr.org\/bph\/hsc\/pubs\/vital\/2006\/vs_21.htmUpdated on April 30 2008. 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