Period: 2012-2014 This cluster RCT funded by CDC to evaluate a complex intervention to promote smoking cessation during pregnancy. The trial is ongoing at 10 public hospitals and their associated Primary Health Centers (PHCs) in Argentina, and 10 in Uruguay. Approximately 7,000 women will be finally enrolled. Researchers Althabe F, Mazzoni A, Gibbons L, Belizán J, Morello P, Becu A. Abstract Argentina and Uruguay are among the countries with the highest proportion of pregnant women who smoke. The implementation of an effective smoking cessation intervention would have a significant impact on the health of mothers and children. The “5 A's” (Ask, Advise, Assess, Assist, Arrange) is a strategy consisting of a brief cessation counseling session of 5–15 minutes delivered by a trained provider, which is considered the standard of care worldwide. However, it is under used in Argentina and Uruguay. We will conduct a two-arm, parallel cluster randomized controlled trial of an implementation intervention in 20 prenatal care settings in Argentina and Uruguay. Our primary hypothesis is that the intervention is feasible in prenatal clinics in Argentina and Uruguay and will increase the frequency of women receiving tobacco use cessation counseling during pregnancy. Our secondary hypothesis is that the intervention will reduce the frequency of women who smoke by the end of their pregnancies. Prenatal care settings will be randomly allocated to either an intervention or a control group after a baseline data collection period. Midwife facilitators in the four intervention clinics will be identified and trained to deliver the “5 A's” to pregnant women and will then disseminate and implement the program. The 10 prenatal care settings in the control group will continue with their standard in-service activities. A follow-up data collection will be conducted immediately after delivery. The intervention will be tailored by formative research to be readily applicable to local prenatal care services at busy maternity hospitals, as well as to be acceptable to local pregnant women and health providers. The study will be conducted in 48 months. objectives Evaluate an intervention aimed at increasing the frequency of women who receive the “5 A's” strategy during pregnancy. Financing Centers for Disease Control and Prevention- (CDC), USA. Study design Cluster Randomized Clinical Research. Publications Althabe F, Alemán A, Mazzoni A, Berrueta M, Morello P, Colomar M, Ciganda A, Becú A, Gibbons L, Llambi L, Gonzalez MG, Tong VT, Farr SL, Smith RA, Dietz PM, Johnson C, Buekens P , Belizan JM. Tobacco cessation intervention for pregnant women in Argentina and Uruguay: study protocol. Reprod Health. 2013 Aug 26;10(1):44. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3765647/pdf/1742-4755-10-44.pdf