Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Cynthia Coviak

Second Advisor

Erin Chillag

Third Advisor

Darcy Lokers


According to the authors of current literature, pregnant women who smoke may be more resistant to change, and may not fully understand the harmful effects of smoking. Therefore, there is agreement among researchers that the use of psychosocial interventions for smoking cessation can be effective. At the time of this project many settings, including clinics, health departments, and providers, were implementing the 5As which guide healthcare and community workers to ask, advise, and assess the smoking status of pregnant women at every health visit, and then assist and arrange smoking cessation interventions if applicable. Despite these efforts, pregnant women are continuing to smoke. The purpose of this project was to implement the clinical practice guidelines of the 5Rs with pregnant women who smoke. The 5Rs were created to reach those people more resistant to change to make the facts and data seem more relevant to them in regards to risks, rewards, and potential roadblocks, and repeat the information as needed. The project involved educating staff of a local health department, which was experiencing a higher than average smoking rate among pregnant women, on the use of the 5Rs. Then the effectiveness with the pregnant women themselves was evaluated. The staff integrated the 5Rs during every visit with the women by talking to the women about the risks of continuing smoking, the rewards of quitting, and the roadblocks of cessation. The collected data were analyzed and results shared for possible dissemination among other county health departments and primary care offices.

Included in

Nursing Commons