4009.0: Tuesday, October 23, 2001 - Board 1

Abstract #24665

Effectiveness and cost benefit of the smoking cessation or reduction in pregnancy treatment model in Medicaid maternity care

Richard A. Windsor, PhD1, Lesa L. Woodby, PhD2, Myra A. Crawford, PhD2, J. Michael Hardin, PhD2, Thomas M. Miller, MD3, and Carlo C. DiClemente, PhD4. (1) School of Public Health and Health Services, George Washington University, 2175 K Street NW #810, Washington, DC 20037, 202.416.0086, sphraw@gwumc.edu, (2) University of Alabama at Birmingham, (3) Alabama Department of Public Health, (4) University of Maryland at Baltimore County

The objectives of this study were to determine the extent to which tobacco exposure assessment and the Smoking Cessation/Reduction in Pregnancy Treatment Model (SCRIPT) patient education methods could be provided routinely by trained public health maternity staff and, to document the behavioral impact of these interventions among pregnant smokers.This project (1996-2000) screened 5,336 patients. Thirty-four percent (n=1,828) were smokers. Of these self-identified smokers, 69% (n=1,262) agreed to participate. Following informed consent, patients were randomly assigned within each of the 10 public health study sites to either experimental (n=625) or control (n=637) groups. All patients received standardized risk information and were advised to quit smoking. The experimental group also received evidence-based patient education methods which included a video, "Commit to Quit" and a self-help manual, "A Pregnant Woman's Guide to Quit Smoking." Saliva cotinine assessments were performed at baseline and at the end of pregnancy to corroborate self-reported smoking status. A significantly higher percentage of patients quit smoking in the experimental group, 15 %, as compared to the control group, 10%. An additional 24% of the experimental group were confirmed as significant reducers versus 16% of the control group. The cost benefit of these levels of behavioral impact were estimated using the Year 2000 Medicaid maternity care population data. It was estimated that a savings of $30 million per year would be accrued using these methods, a cost benefit ratio of $1:$6. These data demonstrated that the application of evidence-based health education methods increased smoking cessation rates and were cost effective.

Learning Objectives: N/A

Keywords: Smoking Cessation, Pregnancy

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA