Background and Rationale Cigarette smoking is the most preventable cause of cancer and is estimated to account for 1 in 5 cancer related deaths. It is estimated that almost 11% of American women report smoking during pregnancy with higher smoking rates in younger women with lower educational levels. Rates of quitting smoking during pregnancy have been reported to ranging from 35-75%. Regrettably, the rates of smoking relapse are particularly high in the post-partum period with an estimated 67% of women eventually relapsing.