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IntroductionInfant mortality rate is listed as one of the leading health indicator of Healthy People 2020 HP2020 United States Department of Health and Human Services HHS 2014 Centers for Disease Control and Prevention also identifies maternal smoking as The most common preventable cause of infant morbidity and mortality Centers for Disease Control and Prevention CDC 2013 Infant mortality represents the health of mothers and future adults of a community and can be used as a measure of health in a population MacDorman Hoyert Mathews 2013 As a result it is important to identify the challenges and provide resources to decrease infant death rate in our country This paper will use the Transtheoretical Model TTM to understand the process of quitting smoking during and after pregnancy and provide guidelines for smoking cessation interventionsAlthough infant mortality has decreased it has not met the target of HP2020 which is 60 deaths per 1000 live birth HHS 2014 Major causes of infant mortality in the US are congenital malfunction short gestation and low birth weight sudden infant death syndrome SIDS maternal complication and accidents Mathews MacDorman 2013 Prevalence of smoking during pregnancy in the US was 114 in 2002 which attributed to 131 190 of term low birth weight 53 77 of preterm deliveries 232336 of SIDS Dietz et al 2010 Comparing infant mortality rate in smoking and non-smoking pregnant women shows that infants of smoking mothers have 40 higher mortality rate than infant of non-smoking mothers Salihu Aliyu Pierre-Louis Alexander 2003 Pregnant women fail to quit smoking compared to successful abstinence from drinking alcohol and using recreational drugs Fingerhut Kleinman Kendrick 1990 They also have 70 relapse rate within one year after delivery postpartum Ruggiero Tsoh Everett Fava Guise 2000 Fortunately the adverse effect of maternal smoking is reversible if smoking mothers quit this habit in early stage of pregnancy McCowan et al 2009 Consequently TTM-based interventions which result in higher abstinence rate
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