Effectiveness of a rural pregnancy smoking intervention: First three years of the TIPS program

Background: In 2007, the TIPS program was funded to reduce pregnancy smoke exposure in Northeast Tennessee. Methods: Smoking cessation counselors, who used a motivational interviewing brief intervention model (5 A's) were available in prenatal practices and offered enrollment to all new prenatal patients smoking at the time of conception. Results: Over a three year period, eligible women (n=1254) were invited to participate, and 1108 (88%) agreed to meet with a counselor at least once. 27% had already attempted to quit smoking, and 80% successfully remained smoke free. An additional 7% subsequently quit smoking and remained smoke free to delivery, for a total cessation rate among all participants of 28%. An additional 15% had at least one quit attempt. Of those who continued to smoke, 63% reduced their smoking levels. Over 10% completely eliminated second-hand-smoke (SHS), and 58% significantly reduced such exposure. Services associated with smoking and SHS changes included meeting with a counselor at least three times, assistance with mental health issues and practical problems, assistance for partners, and absence or elimination of domestic violence issues. Conclusions: Most eligible women were willing to participate, and TIPS was highly successful in helping recent quitters remain smoke free. The program was moderately successful in helping pregnant smokers quit and in reducing their levels of smoking and SHS exposure. A second program phase is underway, and has built on these findings including increasing the number of sessions and providing more assistance with mental health problems, practical life issues, partner smoking, and relationship issues.