Levine and colleagues evaluated the relative effectiveness of 2 different approaches to preventing postpartum smoking relapse. Women received postpartum-adapted smoking relapse prevention intervention and were randomly assigned to cognitive behavioral intervention with content and strategies to address concerns about mood, stress, and weight or a time= and attention-controlled comparison. Overall, 38%, 34%, and 24% of the sample maintained biochemically confirmed sustained tobacco abstinence at 12, 24, and 52 weeks’ postpartum, respectively, with no differences between interventions. Depressive symptoms and perceived stress significantly improved, and women with fewer depressive symptoms and less perceived stress were more likely to achieve abstinence. Cognitive behavioral intervention designed to address postpartum concerns about mood, stress, and weight did not differentially improve rates of sustained tobacco abstinence postpartum relative to a time- and attention-controlled comparison. All women reported improvements in mood and stress, and the experience of fewer depressive symptoms, as well as less stress related to sustained abstinence.