1. B.E.A.T. Program: An Innovative Cessation Program for Pregnant Women Margaret Steele RNC Jacqui Truex-Greenslet RN

2. Project Goals “Babies Extremely Against Tobacco” Provide effective no-cost smoking cessation assistance to all pregnant women in our hospital service area Reduce and eliminate smoking in pregnancy from Vermont state average of 18%to the Healthy People 2010 goal of < 1%

3. Program Description Referrals accepted primarily from OB providers trained in using the 5 A’s B.E.A.T. nurses meet women at prenatal office visits, at delivery and postpartum for brief one-on-one cessation counseling Pregnancy-specific materials and videos are provided along with “A Pregnant Woman’s Guide To Quit Smoking” by Dr. Richard Windsor

4. Program Description, cont. Pre- and post-tests to evaluate: – tobacco use and knowledge – confidence level in making a change – effects of the program 3 Incentives are distributed: –“urge” bag –$10 grocery store gift certificate –baby gift at delivery

5. Research Base Originally a research project initiated at the community level in response to an increase in smoking-related infant mortality in our service area. Early results showed effectiveness and community interest.

6. Research Base, cont. Dr. Richard Windsor was recruited as technical advisor in program development CDC 5 A’s incorporated Prochaska and DiClemente’s Stages of Behavioral Change Theory is used to evaluate progress

7. Key Counseling Methods Motivational Interviewing techniques Pregnancy-focused educational materials Evaluate Stage of Change at each contact Incentive gifts

8. Team/Resources Required Establish strong referral base with OB providers, the hospital, Home Health agencies and Public Health With 500+ births per year, our program requires a nurse 20 hours/week Average 6 visits per participant Completely grant-funded at present

9. Current Status Out of 100+ smokers delivering at our hospital, 75-85 per year voluntarily enroll in B.E.A.T. Quit rate averages 40% Smoking reduction 99-100% Remaining quit postpartum rate 38%

10. Ideas for the Future Add expired Carbon Monoxide measurements so moms “see” the results of their hard work Improve postpartum quit rate Funding to be provided by hospital system with supplemental grants Expansion into Vermont state as its pregnancy cessation model