States Put the Squash on Smoking During Pregnancy

Posted July 24, 2015 by Wendy Loveland

One of the core strategies for lowering the U.S. infant mortality rate is to reduce smoking before, during and after pregnancy. Smoking during pregnancy is associated with multiple fetal health risks, including sudden unexpected infant death.

Currently, 21 of 53 states and territories that are part of the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN) are testing different smoking cessation methods in their communities. Approaches include providing doctors with smoking cessation program information and asking them to refer women who smoke to a smoking cessation program; designating a “quit coach” who provides counseling and support; and extending counseling postpartum.

The primary drivers of the IM CoIIN Smoking Cessation Learning Network
  • Supportive local and state level policies that prevent starting, support stopping, and staying tobacco free for all women in childbearing years
  • Collaborative, community-based partnerships provide resource and psychosocial supports for smokers and former smokers
  • Women, in child bearing years avoid smoking, or stop and stay quit
  • Providers recognize role in coaching and supporting women to stop and stay quit
  • Public sensitivity to and awareness of women not smoking, avoiding and ceasing all forms of tobacco and nicotine in childbearing years.
NICHQ, the backbone organization along with the Maternal and Child Health Bureau for the IM CoIIN, recently sat down with members of two state teams to learn about their small tests to date.

New Jersey
The team is testing the promotion of its new smoking cessation toolkit to providers, which includes information about the state’s comprehensive perinatal smoking cessation program, Mom’s Quit Connection, including instructions on how to refer patients. It is very successful so far, doubling their predictions of a 30 percent increase in requests for training by providers. They were also surprised that in addition to health-related organizations, 67 percent of schools requested training. (The New Jersey team also has a kit for general smoking cessation.)

“One lesson learned is that providing online access to educational, promotional and referral materials to healthcare providers serving pregnant smokers is an effective strategy for engaging them in professional training programs, and supports more targeted and cost effective outreach to those providers who have already expressed an interest in helping smokers quit,” says team member Loletha Johnson, MSN, RN.

Team members are working with a WIC site in Bennington to increase what they have termed “facilitated self-referrals” to the state’s quit line (part of the state’s recently re-branded set of cessation services known as 802Quits). When pregnant women visit the WIC office and are identified as smokers, they are shown the website and can register for quitline or quit online cessation services via a computer in the office.

“It is a great opportunity for the WIC counselor to engage with the client,” says team member Eoana Sturges. “They realize we are not out to shake our fingers at them.” Their goal is to increase these referrals by 5 percent. They are still in the planning stage.

To learn more about NICHQ's infant health work, visit the infant health section of our website.


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