January 24, 2002

Contact: Bonnie Widerburg, (971) 673-1282

Technical Contact: Donalda Dodson, (503) 731-4398

Grant will help pregnant smokers quit tobacco

A new grant will help the Oregon Department of Human Services (DHS) assist pregnant smokers in their efforts to quit, thus decreasing the number of infants harmed by tobacco.

The funding is from The Robert Wood Johnson Foundation (RWJ) Smoke-Free Families program and amounts to $200,000 for the first year of a three-year smoking cessation project for a potential maximum of $600,000. Oregon's project, called the Smoke Free Mothers and Babies program, is the first of its kind to be funded through the Smoke-Free Families program.

"Tobacco has serious health consequences for moms and babies," says Donalda Dodson, administrator for DHS family health programs. "Many pregnant women want to stop smoking but they don't have the support they need. Now they will get help."

Dodson says DHS will work primarily with health providers who serve women enrolled in the Oregon Health Plan, where data show women have higher smoking rates.

In 1999, almost 15 percent of Oregon women who delivered babies reported they had smoked during pregnancy. Pregnant women enrolled in Medicaid had much higher rates, with about 28 percent reporting they smoked while pregnant, according to Dodson.

Ten counties will participate in the first year of the program and the intention is to eventually expand statewide. They are Columbia, Coos, Deschutes, Douglas, Hood River, Jackson, Jefferson, Klamath, Lincoln and Yamhill. Providence Beginnings, a hospital maternity case management program in Portland, is also participating. Smoke Free Mothers and Babies is based on an intervention developed through 15 years of research. Called "5-A," it's been shown to increase cessation rates among pregnant women by 30 to 70 percent. It involves five steps:

• Ask the pregnant woman if she smokes,
• Advise her about the benefits of quitting and the impact of smoking and quitting, both for herself and her baby,
• Assess her willingness to make a quit attempt within the next 30 days,
• Assist her with ways to quit, such as providing pregnancy-specific self-help smoking materials, problem-solving methods and skills, and helping to arrange social supports,
• Arrange, during follow-up visits, to track her progress in quitting.

The program will be incorporated into cessation counseling offered by maternity case managers, prenatal care providers and the toll-free Oregon Tobacco Quit Line, according to Dodson. "A strength of this program is that it builds on other state and local systems and it will coordinate efforts," she says.

"Through this five-step program we think we have an opportunity to keep infants healthy as well as improve women's long-term health if they quit during pregnancy and beyond," says Cathy Melvin, Ph.D., MPH, director of the Smoke-Free Families National Dissemination Office at the University of North Carolina at Chapel Hill and a lead "5-A" researcher. "We're pleased to help Oregon adopt this intervention."

According to the U.S. Surgeon General, 20 percent of low birth weight births, eight percent of premature births and five percent of all infant deaths are linked to smoking during pregnancy. Risks include tubal pregnancy, miscarriage, pre-term delivery and other life-threatening complications.

"Women who smoke also face long-term health risks including lung cancer and cardiovascular disease," Dodson says. "Their children, who breathe secondhand smoke, are vulnerable to a host of health problems and particularly respiratory illnesses. Studies show that every dollar spent on preventing a mother from smoking saves $3 in medical costs."

The project is part of a broad effort by RWJ to ensure that evidence-based smoking cessation interventions become a routine part of prenatal care nationwide. RWJ, based in Princeton, N.J., is the nation's largest philanthropy devoted exclusively to health and health care. It concentrates its grantmaking in four goal areas: to assure that all Americans have access to basic health care at reasonable cost; to improve care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to educate the personal, social and economic harm caused by substance abuse--tobacco, alcohol, and illicit drugs.