Infant Morbidity Decreases with the BABY & ME – Tobacco Free Program
Financial incentives for low-income women to quit smoking during pregnancyimprove lives and saves Colorado millions in healthcare costs
Local efforts to protect low-income women during their pregnancy through incentive-based smoking cessation interventions have effective and replicated across the United States with BABY & ME – Tobacco Free Program (BMTFP).
A new study from the partnership of Rocky Mountain Health Foundation and Colorado School of Public Health at the Anschutz Medical shows a significant reduction in infant morbidity due to the program. The study, Impact of an Incentive-Based Prenatal Smoking Cessation Program for Low-Income Women in Colorado, published in Public Health Nursing, examines the results of the interventions provided by the BABY & ME – Tobacco Free Program (BMTFP) throughout Colorado.
“Young women, especially when raised in low-income households, are a vulnerable target for tobacco use,” said Tessa Crume, PhD, MSPH, associate professor at the Colorado School of Public Health, and lead researcher in the study.
In Colorado, smoking in the third trimester of pregnancy is three to four times higher among women who live in poverty relative to women with higher incomes, according to Colorado Pregnancy Risk Assessment Monitoring System 2012-2014. Smoking during pregnancy is the most substantial modifiable risk factor for infant morbidity and mortality in the United States.
“The problem of prenatal smoking will not go away, especially when tobacco products target a younger generation, and nicotine addictions begin before becoming pregnant. This study is important because successful interventions improve the health of mothers and children, disrupt familial propagation of tobacco use while also saving Coloradans millions in healthcare costs,” Crume said.
The BMTFP intervention includes counseling (based on motivational interviewing) provided throughout the pregnancy and postpartum period, biomonitoring feedback via carbon-monoxide breath testing and financial incentives in the form of diaper vouchers contingent on cessation-status.
Key findings from the study include:
Reduction in infant morbidity: BMTFP participants had a 24% to 28% reduction in the risk of preterm birth and a 24% to 55% reduction in the risk of neonatal intensive care unit (NICU) admissions.
Significant cost savings: Significant cost savings: Cost savings per participant in BMTFP compared to the birth certificate population is $6,040 and Pregnancy Risk Assessment Monitoring System (PRAMS) reference PRAMS is $2,182. Total annual cost savings for Colorado associated with the BMTFP intervention was up to $4,144,118 compared to the birth certificate and PRAMS reference populations, respectively.
A partner or a family member that lives with mother and who also smokes, can participate in the program, doubling the incentive – free diapers each month.
Lisa Fenton Free, director, BABY & ME - Tobacco Free Program, Rocky Mountain Health Foundation
“Baby & Me Tobacco Free Program continues year after year to improve the lives of mothers, babies, and even family members as well. To prevent preterm deliveries, low birth weights, and improve their overall health is impactful immediately and for years to come.”
Laurie Adams, executive director, national BABY & ME - Tobacco Free Program
"This timely research confirms that BMTFP in Colorado is reducing the burden of tobacco on the pregnant population and leading to substantial cost savings. We hope this research will spur greater interest in scale and sustainability efforts in Colorado and across the nation. We congratulate everyone involved in this effort and we look forward to our continued partnership."
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