GIFTS (Giving Infants and Families Tobacco-free Starts): A Bundled Approach to Help Pregnant Mothers Quit Smoking

Introduction: Nationally, Kentucky ranks second highest in prevalence of women who smoke during pregnancy (26.7% vs. 13.2%). Adverse pregnancy complications including low birth weight infants, preterm birth and SIDS is associated with prenatal smoking and SHS exposure. The goal of the GIFTS pilot is to reduce prenatal smoking in 9 rural counties of eastern Kentucky.

Method(s): Collaboration between the University of Kentucky and Kentucky Department for Public Health initiated GIFTS. Trained employees offered an innovative bundling of research-based interventions while incorporating incentives at three time points. Interventionists trained in motivational interviewing and 5 A's counseling also screen for social support, depression, domestic violence and SHS exposure. Biomarker validation of smoking status (Carbon Monoxide levels) and all program elements are recorded in a comprehensive database.

Results: In a 23 month period, 1519 pregnant women that smoke were identified; 52% enrolled; 48.6% set quit dates; and 22.4% quit smoking. 918 women had a positive screen for depression, domestic violence, social support or secondhand smoke exposure. Nearly half (42%) of GIFTS participants consented to a fax referral to KY QuitLine. Characteristics of QuitLine participants will be contrasted with those declining this service using demographic, smoking status and social support variables.

Discussion: Clearly the GIFTS program is increasing quit attempts, quit rates and referrals to the KY Tobacco Quit line. Intervention bundling, individualized support, biomarker validation and incentives may be a necessary component of smoking cessation programs in high-risk populations and regions.