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2.  Ask if the recipient is a smoker.  Encourage smoking cessation.  Discuss the effects of smoking on the infant to include: increased risk of prematurity, low birth weight, infant mortality, and a sicker infant. 2

3.  Use the most effective evidence-based method suitable to your area to assist moms to stop smoking.  Encourage the use of the Alabama Department of Public Health Quitline for counseling and ask her to discuss with her doctor the possibility of obtaining a prescription to help her stop smoking. 3

4. 4 QUIT SMOKING

5.  Review smoking cessation with women who smoke.  Utilize the most appropriate evidence based methods.  Encourage to cut down and quit.  Explain harmful effects to the fetus.  If she states that she has quit or cut down on the number of cigarettes that she smokes, praise her efforts. 5

6. Coverage of Smoking Cessation Products Effective February 1, 2010, smoking cessation products for pregnant females will be covered as a component of the Maternity Care Program.  1. Prior authorization through the Pharmacy Administrative Services contractor, Health Information Designs, will be required.  2. The recipient must be enrolled and receiving counseling services through the Alabama Department of Public Health Quitline (1-800-784-8669).  3. Approval will be granted for up to three months at a time. Subsequent approvals are contingent upon the recipient’s continued participation in counseling services through the ADPH Quitline which must be certified by the prescribing provider or Maternity Care Coordinator as a component of the prior authorization request.  4. Only one course of therapy will be approved per pregnancy. Providers with questions regarding prior authorization for smoking cessation products may contact Health Information Designs at 1-800-748-0130. 6

7.  Pharmacy Prior Authorization Form 470 must be completed and submitted to HID  The Physician providing the prenatal care must attest to the fact that the recipient is meeting the requirements which includes participation with counseling through the Quitline. 7