Learning Objectives: Identify at least one effective strategy and at least one challenge for the successful implementation of a community-based perinatal smoking cessation program.
Abstract: Tobacco use during pregnancy is associated with well-documented, significant health risks for mother and baby. The San Mateo County Health Services Agency, Public Health and Environmental Protection Division, developed the “Smoke Free Start for Families Program” (SFSF) to offer free perinatal smoking cessation services for County residents. Most SFSF clients are from underserved and vulnerable populations accessing public assistance programs, although some clients are referred by private for-and non-profit health care providers. During 2001, one-third of pregnant clients were Non-Hispanic White, 28% Hispanic/Latino, 20% African American, and 13% Asian/Pacific Islander. Referred clients are matched with culturally and linguistically appropriate cessation specialists who provide individualized counseling by phone or in person. Since December 1997, SFSF has received 418 referrals and enrolled 219 pregnant and 56 postpartum women. To date, the quit rate among the pregnant smokers is 34% and the abstinence rate among former smokers is 83%. The postpartum quit rate is 29% with a 56% abstinence rate. Program evaluation data suggest that SFSF success stems first from concerted efforts to enhance referrals through community outreach activities, provider office visits, a social marketing campaign, and a systems change strategy at the County hospital (i.e., chart reviews; standardized intake interviews). Additionally, the use of an innovative, personalized telephone counseling service enables cessation specialists to tailor sessions based on client needs and readiness to quit. Major challenges encountered include: dependence on referrals from overextended health care providers; and working with impoverished, poorly educated clients who have unstable living situations.
SFSF Slides.ppt (120.0 kb)
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