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Issues regarding perceived stress and depressive symptoms as predictors of smoking cessation during pregnancy are discussed. Prenatal healthcare providers should continue providing intensive cessation interventions based on level of addiction. Interventions reducing psychological symptoms may also help women still smoking in early pregnancy.

Insurance plans that fully cover smoking cessation programs are more likely to be cost-effective. Researchers compared the cost, usage and effectiveness of full coverage or reduced coverage for smoking cessation programs. The use of smoking cessation plans was higher by smokers who were fully covered compared to those partly covered. In addition, about four times as many smokers in the fully covered plans would quit smoking per year. However, the cost of full coverage was higher.

Objectives. This study examined whether pregnancy intention was associated with cigarette smoking, alcohol drinking, use of vitamins, and consumption of caffeinated drinks prior to pregnancy and in early pregnancy. Methods. Data from a telephone survey of 7174 pregnant women were analyzed. Results. In comparison with women whose pregnancies were intended, women with unintended pregnancies were more likely to report cigarette smoking and less likely to report daily vitamin use. Women with unintended pregnancies were also less likely to decrease consumption of caffeinated beverages or increase daily vitamin use. Conclusions. Pregnancy intention was associated with health behaviors, prior to pregnancy and in early pregnancy, that may influence pregnancy course and birth outcomes. (Am J Public Health. 1998; 88:663-666)

The incremental effects of (a) a self-help booklet alone, (b) self-help booklet with computer-generated personalized feedback, and (c) self-help booklet, personalized feedback, and outreach telephone counseling were evaluated in a population-based, nonvolunteer sample of smokers. Smokers (N = 1,137) were identified through a telephone survey of a random sample of 5,903 enrollees in a health maintenance organization and randomized to a no-treatment control group or 1 of the 3 intervention conditions. Smoking status was ascertained 3, 12, and 21 months postrandomization. Cotinine validation of self-reported cessation was obtained at the 12-month follow-up. Overall, the telephone counseling significantly increased smoking cessation at the 3-month follow-up, but not at 12 or 21 months. Among smokers who were precontemplative at baseline, telephone counseling significantly increased prevalent abstinence at 3 and 12 months and continuous abstinence at 21 months (defined as self-reported abstinence at 3, 12, and 21 months).

Functional decline is usually considered a part of the aging process. Some researchers have proposed that functional decline in older adults is something that can be minimized or avoided completely by health-promoting interventions. There has been growing interest in health promotion and disability prevention programs for the elderly. In an effort to better understand how at-risk populations can be reached by such programs, health and life-style characteristics were compared between participants and nonparticipants in a senior health promotion program. Specifically, health status and health behaviors were identified from responses to a questionnaire completed by 2,289 participants in the program; this data were compared with that obtained from 175 nonparticipants interviewed by phone. Overall, nonparticipants had a lower income, less education, and were less involved in community organizations than participants. Nonparticipants smoked more and evaluated their health as poorer than participants. However, there were few differences in health status indicators and the incidence of high risk behaviors between the groups. The contention that sicker, more sedentary elderly with high risk behaviors (those most in need of the program) are less likely to participate was not supported by these findings. Nonparticipants were no more likely than participants to have been hospitalized, to have fallen, or to have taken illness-related medications during the past year. It is surmised that health promotion programs for the elderly do not necessarily attract participants that are more physically active and healthy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Personalized feedback and a financial incentive, developed from an intrinsic/extrinsic motivation framework, were evaluated as adjuncts to self-help materials for smoking cessation. Ss (N = 1,217) were randomized to 4 treatment groups and were followed up at 3 and 12 months. Consistent with hypotheses derived from the motivation framework, the financial incentive increased the use of self-help materials, did not increase cessation rates among program users, and was associated with higher relapse rates among those who did manage to quit. The personalized feedback increased both smoking cessation and use of the materials 3 months after distribution of the materials. Continuous abstinence (abstinence at 3 and 12 months) in the group that received the personalized feedback alone was twice the rate of the other groups.

The fallopian tube conveys an egg, or ovum, from the ovary to the uterus, and sperm from the uterus toward the ovary. Tubal ligation (tying the fallopian tubes) causes female sterilization and is a common form of birth control in the US. However, tubal sterilization may lead to menstrual dysfunction and an increased risk of hysterectomy, one of the most common operations in this country. It has been suggested that tubal ligation may disrupt blood flow or the nerve supply to the ovaries. Concern has also been raised that a woman who has had tubal sterilization may be more inclined to accept surgical treatment for gynecological disorders. To determine whether this procedure increases the long-term risk of hysterectomy, 7,414 women who had tubal sterilization, 25,736 women who were not sterilized, and 5,323 women whose husbands had vasectomies were evaluated. Women who had tubal sterilization procedures were 1.6 times more likely to have hysterectomies than nonsterilized women, and those who were sterilized before the age of 30 had a 3.4 times greater risk of hysterectomy. However, the risk for hysterectomy did not significantly differ between married sterilized women and those whose husbands had vasectomies. In addition, there was no increased risk for married women who were sterilized over the age of 30. The rate of hysterectomy did not vary according to the technique used for tubal sterilization. Most sterilized women had hysterectomies due to excessive uterine bleeding or pelvic relaxation (decreased support and tone of pelvic organs and structures associated with childbirth). In contrast, unsterilized women usually had hysterectomies because of benign or malignant uterine growths. The results suggest that younger sterilized women and unmarried older sterilized women may have an increased risk for hysterectomy, but it is probably not related to physiological factors. Further research is recommended. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diabetics who are successful in controlling their blood sugar will incur fewer health care expenses, according to a study of 4,744 diabetics. Average total health care costs were $685 to $950 less each year in the diabetics who were able to control their blood sugar.