Problem/Objective: Wisconsin's rate of smoking during pregnancy (2005) is 13.4%, corresponding to roughly 9,503 smoking-affected births each year. Even higher rates are seen among low-income women.

Methods: The Wisconsin Women's Health Foundation's prenatal smoking cessation is a unique collaboration among non-profit, public and private health organizations. First Breath and its partnering agencies train prenatal care clinicians in the program protocols, the 5As counseling technique and motivational interviewing. The program is incorporated into existing prenatal care facilities that pregnant women regularly access.

Results: The program has grown from a pilot study with 7 sites in 2001 to a statewide program with 109 sites in 60 (of 72) counties in 2007. Over the last 5 years, First Breath has served 4,804 women across Wisconsin. Through self-report, 36% of participants report that they are not smoking at the last data entry point before delivery.

Conclusions: The First Breath approach has been successful in helping low-income pregnant women quit smoking. Essential elements include providing prenatal care clinicians with training, program tools and education materials, minimal data collection requirements, and follow-up technical assistance and support.