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Reducing Prenatal/Postpartum Tobacco Use
Healthy Babies - Born On Time
TPHA Annual Conference
“Health and Home - Where You Lives Matters”
September 11, 2014Laurie Adams, Cessation Specialist
Executive Director
BABY & ME – Tobacco Free Program
1. Best-Practice Approach – Tenn. Data and Helping Patients Quit
1. Implement Policy Change/System Change-Screening for Tobacco Use, Motivating them to Quit
2. BABY & ME – Tobacco Free Program
TPHA Presentation Objectives:
Goal: We MUST reduce the burden of tobacco on our society
Objective: To improve birth outcomes by reducing tobacco use among prenatal/postpartum women
Tennessee Data - Low Birth Weights
2012 March of Dimes:
From 2002 – 2012 no change in low-birth weights
Low-birth rates – less than 5 ½ lbs.
Low-birth rates Tennessee 2002-2012
Tennessee Data - Preterm Births
Preterm Births : Tennessee 2002-2012
2012 Tennessee Data:
Between 2002 and 2012, the rate of infants born preterm in Tennessee declined 1.3%.
Preterm – less than 37 weeks
Tennessee Smoking RatesIncome and InsuranceSmoking during pregnancy by income: Tennessee, 2009 Smoking during pregnancy by insurance: Tennessee 2009
*PRAMS report
Cost of Prenatal Smoking
Health Care Dollars!
Average cost of delivery to non-smoking woman: $3,500 per stay
Average cost of complicated delivery: $12,000 per stay
Average cost per day in Neo-natal Care: $72,000 per day
*2007 March of Dimes, Cost of Prenatal Smoking
Quitting Smoking Improves Birth Outcomes…
Prevents Premature BirthsReduces Low-Birth RatesReduces Placental Abruptions & StillbirthsImproves blood flow and oxygen to babyReduces the risks of SIDS (sudden-infant-death)Reduces risks for future health and behavioral problems
2014 CDC Division of Reproductive Health, report Preventing Tobacco Use During Pregnancy
Best-Practice Approach -Helping Patients Quit
US Department of Health and Human Services, Clinical Practice Guideline Treating Tobacco Use and Dependence (2008 Update)
We MUST screen for tobacco use at every visit
5 A’s Model 1. Ask
2. Advise 3. Assess
4. Assist 5. Arrange
Follow the 5 A’s Model
1. ASK – Every visit … Every time
2. ADVISE – “I need to let you know that quitting smoking is the most important thing you can do for your health and the health of your baby! “We are committed to helping you quit.”
3. ASSESS - “Are you willing to give quitting a try?”
Follow the 5 A’s Model
4. ASSIST – - Provide or refer to counseling- Refer patients to programs that work- State Quitlines
5. ARRANGE –- Provide follow up at next visit
Motivational Interviewing Skills
• Reflective Listening – Low SES Population• Craft response using statements such as:
“It sounds like…”“I understand…”“May I share…”
Why it works?Mindful, Respectful, Kind, Empathic,
Helps direct your next steps….
BABY & ME – Tobacco Free Program
Evidenced-Based Prenatal/Postpartum Program Researched from 2006 – 2009 NY State Dept. of Health, Bassett Research Institute
Consistent 60% + quit rate, at 6 months postpartum Core Program Components:
Provides 4 prenatal sessions Monthly postpartum visits, 12 months
Provides FREE Diapers, Postpartum for up to one-year Tested at every visit
BABY & ME – Tobacco Free Program
• Tennessee Project• Trainings April – May 2014 • 56 Counties Participating• 241 Staff Trained• 976 Women – Enrollment Goal (2014 – 2017)• Investment 1 million • ROI (return-on-investment) – 68.3 Million
Mid-Cumberland
Rural Health Regions
West
South Central Southeast
East Northeast Upper
Cumberland
Why the SUCCESS?…
Positively reinforces quitting tobacco and behavioral changes. Win-Win for funders, doctors, agencies, mothers and babies. HUGE ROI (return-on-investment)
BABY & ME – Tobacco Free Program
New Book – Released Sept 2013
Media Messages -
Healthy Babies – Born On Time …..Laurie Adams, Executive Director
BABY & ME – Tobacco Free Program
716-484-3325
Lindsay Ball, Director of Program Services
716-244-7227
Website: babyandmetobaccofree.org
Facebook: Baby & Me Tobacco Free
Twitter: @BabyAndMeHealth