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Research to help pregnant women stop smoking

October 9, 2013

Public health researchers at Indiana University received a three-year, $900,000 grant from the Indiana State Department of Health to study the cost benefit of new, innovative strategies to reduce smoking during pregnancy.

One of the Indiana State Department of Health’s top three initiatives is to lower the state’s infant mortality rate, which is sixth worst in the United States. Smoking during pregnancy is a major contributor to infant mortality, and Indiana has one of the highest rates of smoking during pregnancy: 16.6 percent compared to 13 percent nationally.

“The State Health Department deserves a lot of credit for tackling this important public health issue for Indiana by investing in research to identify effective interventions that will save most importantly lives, but also scarce resources,” says Jon Macy, lead researcher for the project and assistant professor at the IU School of Public Health-Bloomington. “We really need to lower the rate of smoking during pregnancy in Indiana, so I’m excited to get started on this project.”

Women who smoke during pregnancy have more than twice the risk of delivering a low-birth-weight baby, and babies of mothers who smoked during pregnancy have twice the risk of sudden infant death syndrome.

Macy is working with a team of researchers from the IU School of Public Health-Bloomington and the Richard M. Fairbanks School of Public Health at Indiana University-Purdue University Indianapolis. One researcher is from Florida International University.

Women will be enrolled in the study at prenatal clinics in central and south-central Indiana. They will be followed throughout their pregnancy and for up to six months after delivery to assess the effect of the intervention on smoking and health outcomes.

The study will involve different levels of financial incentives, with a working hypothesis that the incentives would be much cheaper than the medical expenses associated with a pre-term, low-birth-weight baby.

Smoking is a difficult habit for anyone to quit, but pregnant women have additional challenges, according to Macy.

“One consideration unique to pregnant women is whether the physician thinks it’s OK to use nicotine replacement therapy,” he says. “Quitting without nicotine replacement is more difficult. The other unique consideration would be remaining abstinent from smoking after the baby is born. Many women successfully quit during the pregnancy but then relapse soon after the birth of their child. We will be following the women for up to six months after delivery to see if our intervention has any lasting effect.”

Members of the team include Susan Middlestadt, associate professor, and Rachel Dowty, research associate and director of this research project, IU School of Public Health-Bloomington; Greg Wilson, professor and associate dean for global and community health, and Stephen Jay, professor, Fairbanks School of Public Health; and Alejandro Arrieta, assistant professor in the Robert Stempel College of Public Health and Social Work at Florida International University.