Back to Annual Meeting

Back to Annual Meeting

Abstract #146741

Sarah T. Tran, MPH, Environmental Health Investigations Branch, California Department of Public Health, 850 Marina Bay Parkway, Building P, 3rd floor, Richmond, CA 94804, 510-620-3641, sarah.tran@cdph.ca.gov, Kenneth D. Rosenberg, MD, MPH, Office of Family Health, Oregon Department of Human Services, 800 NE Oregon Street, Suite 850, Portland, OR 97232, and Nichole Carlson, PhD, Public Health and Preventive Medicine, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd., Mail Code CB 669, Portland, OR 97239-3098.

Background: A smoking cessation protocol called the Five A's (Ask, Advice, Assess, Assist, Arrange) has been shown to increase quit rates by 30-70% among pregnant smokers when delivered by a prenatal care (PNC) provider. There is evidence that patients from racial/ethnic minority groups do not receive adequate health promotion counseling, including about smoking, during PNC as compared to patients from the majority white population.

Methods: Weighted logistic regression was performed on data from the 2000-2001 Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) that collects information about whether women received three of the Five A's (Ask, Advice, and Assist; the Three A's) during PNC. The unweighted response rate was 72.6% (N= 3,895). The study population comprised of first-trimester pregnant smokers.

Results: Of the 594 pregnant smokers, only 42.2% of them reported receiving the Three A's. Smoking counseling was not offered uniformly across race/ethnic groups. Despite having the highest smoking prevalence, Native American women were 0.45 times as likely (95% CI: 0.24, 0.85) as Whites to recall having received the Three A's (in a multivariate logistic model). In contrast, Blacks were 2.43 times more likely (95% CI: 1.16, 5.10) than Whites. The relationships remained statistically significant after controlling for socioeconomic factors.

Conclusions: Most pregnant smokers of all races did not receive adequate assistance to quit, indicating that there is a need to improve the training of PNC providers to address tobacco dependency. The need for this training may be most urgent in providers who care for Native American women.

Learning Objectives:

• Become familiar with the Oregon PRAMS survey.
• Identify the population of Oregon pregnant women who are at highest risk of not receiving smoking cessation interventions from health providers.
• Discuss the importance of helping pregnant women stop smoking.

Keywords: Smoking, Underserved

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.