Collaborative practices to promote tobacco-free homes for young children

Abstract: Parental smoking is a reversible risk to fetal and child health. Within central PA, 20% of women reported smoking in the last 3 months of pregnancy. Nationwide, 50% of women who quit smoking during pregnancy rebound within 6-months. Over 15% of children in Pennsylvania live with a smoker. Tobacco use is highest among the younger, lower-income, and less educated, many of whom are without access to healthcare. Parent-smokers often belong to this cohort.

This pilot leverages collaboration between clinicians who have recurring contact with young families anda non-profit agency focused on wellness and resources to provide services at no cost to clients.  Pregnant- and parent-smokers are assessed for readiness to quit at each prenatal and well-infant clinic visit. Along with consistent messages and nicotine replacement therapy (NRT), smokers are offered a referral for community-based cessation counseling.
When accepted, referrals are faxed and contact is initiated within 24 hours. Cessation plans are individually tailored; duration of services varies according to the smoker’s preference.

Audience: Healthcare providers and community agencies focused on child health and cessation.

Key Points: Parental efforts with cessation and tobacco-free homes are successful when reinforced through collaboration.

Educational Experience: Describes intervention model, evaluation methods lessons learned.

Benefits: Evaluation data is reported for the project’s initial 6-months. Primary outcomes, derived from medical records, include parental reports of smoking behaviors, sustained cessation beyond pregnancy, and maintenance of tobacco-free home and car. Other measures include documentation of physician-provided interventions and agency-reported outcomes of referral-initiated counseling.