Smoking Still Matters Before, During and After Pregnancy
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- Melanie Walters
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1 Smoking Still Matters Before, During and After Pregnancy Maternal, Child and Adolescent Health (MCAH) Division Center for Family Health August 25, 2015 Photo: MCAH Library
2 Maternal Tobacco Control Collaboration In 2012, Director created Inter-Program Collaboration Contest challenge Partners: Maternal, Child and Adolescent Health Division, California Tobacco Control Program, California Smoker s Helpline, Medi-Cal, Medi-Cal Incentives to Quit Smoking Project, Text4baby/Quit4baby, Environmental Health Investigation Branch Key Activities: Established partnerships Developed tailored materials and resources with consistent messaging Used data to advance program activities and cessation efforts Integrated tobacco control efforts into direct service programs
3 Why Smoking Matters? Life Course Perspective Before Pregnancy Reduce fertility and conception Sensitivity to nicotine addition greater among younger adults than older. During Pregnancy (Complicatons) Placenta previa, placental abruption, Premature rupture of membranes, Low birth-weight, premature delivery and stillbirth Greater likelihood offspring will also be smokers. After Pregnancy (impact on children) Sudden Infant Death Syndrome (SIDS) Increased asthma Bronchitis Pneumonia Ear infections Secondhand Smoke/Thirdhand Smoke Better Maternal and Infant Health Outcomes
4 Maternal and Infant Health Assessment (MIHA) Survey MIHA is an annual population-based survey of women with a recent live birth, with data from MIHA collects information about smoking at 3 time points: 3 months before pregnancy 3 rd trimester of pregnancy After pregnancy MIHA is a collaborative effort of: Maternal, Child and Adolescent Health (MCAH) Program California Women, Infants and Children (WIC) Program The University of California, San Francisco (UCSF) Genetic Disease Screening Program (GDSP)
5 Smoking during the third trimester of pregnancy PRAMS and MIHA, Data Source: Maternal and Infant Health Assessment (MIHA) Survey, and Pregnancy Risk Assessment Survey (PRAMS), Notes: PRAMS estimates based on 40 PRAMS sites. MIHA data are weighted to represent all women with a live birth in California for a given year.
6 Smoking before, during, and after pregnancy PRAMS and MIHA, 2011 HP 2020 Objective* Data Source: California data - Maternal and Infant Health Assessment (MIHA) Survey, Pregnancy Risk Assessment Monitoring Survey, Notes: MIHA data are weighted to represent all women with a live birth in California in *No HP 2020 objective exists for smoking after pregnancy.
7 Smoking before, during, and after pregnancy by race MIHA Data Source: Maternal and Infant Health Assessment (MIHA) Survey, Notes: MIHA data are weighted to represent all women with a live birth in California.
8 Smoking before, during, and after pregnancy by prenatal health insurance, MIHA Data Source: Maternal and Infant Health Assessment (MIHA) Survey, Notes: MIHA data are weighted to represent all women with a live birth in California for a given year.
9 White women on Medi-Cal have a high prevalence of smoking during pregnancy ( ) Data Source: Maternal and Infant Health Assessment (MIHA) Survey, Notes: MIHA data are weighted to represent all women with a live birth in California for a given year.
10 Most women quit smoking during pregnancy However, one-third of women who quit relapsed postpartum Data Source: Maternal and Infant Health Assessment (MIHA) Survey, Notes: MIHA data are weighted to represent all women with a live birth in California for a given year.
11 Promote Tobacco Cessation Services Affordable Care Act requires both Medi-Cal and private insurance to cover comprehensive tobacco cessation benefits for pregnant women, including counseling and medication. 1 Cessation programs for pregnant women save money Spending $1 save $3. 2 Four out 10 women of reproductive age who smoke have not been advised to quit by their health provider 3 Use the Ask, Advise and Refer approach it takes just 3 minutes!4 1. Jennifer Singleterry, MA, Zach Jump, MA, Elizabeth Lancet, MPH, Stephen Babb, MPH, Allison MacNeil, MPH, Lei Zhang, PhD. (2014). State Medicaid Coverage for Tobacco Cessation 2. Ruger JP, Emmons KM. Economic evaluations of smoking cessation and relapse prevention programs for pregnant women: A systematic review. Value in health 2008;1(2): Treatments and Barriers to Coverage United States, MMWR., 63, Behavioral Risk Facto Surveillance System- California Adult Tobacco Survey, Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.
12 Smoking: Before, During and After Pregnancy Fact Sheet
13 Smoking: Before, During and After Pregnancy Fact Sheet: Data Table
14 Smoking: Before, During and After Infographic
15 Still More Work To Do! Although the prevalence of prenatal smoking is low in California, smoking among pregnant women is an important public health issue because it s a preventable health risk factor for adverse birth outcomes. Women are still smoking before and after pregnancy. As disparities persist, we must continue to work collaboratively.
16 Additional Resources Learn more about MCAH: To learn more about the Maternal and Infant Health Assessment (MIHA), visit: Fact Sheet and Infographic : CDC, Smoking and Reproduction CDC: Smoking and Reproduction
17 Thank You! Maternal, Child and Adolescent Health Division Martha E. Dominguez, MA, MPH Program Consultant Policy and Program Standards Branch Phone: (916) Melanie Dove, ScD, MPH Research Specialist Epidemiology, Assessment and Program Development Branch Phone: (916)
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