Selected Podcast

Baby & Me: Tobacco Free

A new initiative at Newark-Wayne Community Hospital is encouraging pregnant moms to kick their smoking habit. he program involves staff training, as well as screening and referrals to smoking cessation programs for pregnant women who smoke. In exchange for giving up smoking, expectant mothers receive vouchers for diapers.

Pregnant women who quit smoking are less likely to have premature and low birth weight babies.

Listen in as Tara Louise Gellasch, MD explains how Newark-Wayne Community Hospital works to keep babies healthy by preventing birth defects, premature births and infant mortality.
Baby & Me: Tobacco Free
Featured Speaker:
Tara Louise Gellasch, MD
Tara Gellasch, MD, is the Chief of Obstetrics and Gynecology at Newark-Wayne Community Hospital (NWCH) and sees patients at The Women’s Center at NWCH, a Rochester General Medical Group practice. Dr. Gellasch earned her Medical Doctorate from McGill University in Montreal, Quebec and completed her residency in Obstetrics and Gynecology at Emory University.

Learn more about Tara Gellasch, MD
Transcription:

Bill Klaproth (Host): Smoking and pregnancy--not a good match. Women who quit smoking while pregnant are less likely to have premature and low birth weight babies, resulting in healthier babies and mothers. Here to talk with us more is Dr. Tara Gellasch. Dr. Gellasch, thank you so much for your time today. Is it tough for some women to quit smoking during pregnancy even though they may have a big incentive?

Dr. Tara Gellasch (Guest): Absolutely. We know that the nicotine addiction is actually very, very powerful and despite being pregnant and wanting to do the best for their babies, many women who try to quit smoking during pregnancy will ultimately relapse. We know that about 70% of women who actually quit smoking while pregnant will, unfortunately, relapse and go back to smoking.

Bill: You know, I mentioned a little bit in the open, but why is cigarette smoking so bad for the unborn baby and the mother during pregnancy and after?

Dr. Gellasch: Well, unfortunately, cigarettes have multiple effects on the mom and the baby. We do see a significant increased risk of pre-term labor and pre-term delivery and babies that are born early can have a large number of problems ranging from cerebral palsy, asthma, blindness, deafness--a whole host of issues depending on how early they are born.

Other issues can be things like placental abruption, which can actually be life-threatening to both mom and baby and then, even earlier on, we see a higher risk of ectopic pregnancies in women who smoke. These are pregnancies that actually develop in a fallopian tube instead of in the uterus where they belong.

Bill: So, there is a big list of things that really can go wrong or affect the pregnancy--things that you don't want. Still, it is very tough to quit smoking, as you told us, so can you talk about the Baby and Me Tobacco Free program? Give us an overview of that.

Dr. Gellasch: The Baby and Me Tobacco Free program is actually and evidence-based program for helping pregnant women quit smoking and this is an incentive program, so what I mean by that is women actually can earn a monetary incentive if they quit smoking and stay quit.

So, initially what happens is that in the doctor's office, as the doctor is doing just routine screening during the pregnancy, the doctor discovers, or the midwife, or the medical provider, discovers that the woman is a smoker and that patient can then be referred to the program. The patient then meets with a smoking cessation counselor or facilitator who will sit down with the patient and discuss the details of the program. If the patient is motivated to quit smoking, then she can enroll in the program and she can stay enrolled in the program throughout the pregnancy, but also up to a year post-partum.

The woman can then come into the office once a month and if she can prove that she has quit smoking and has remained quit, then she can earn a voucher for diapers--a $25 voucher for free diapers. The way the woman can prove that she quit smoking and she has stayed quit is we actually have CO monitors. So, it's a carbon monoxide monitor that she blows into at each visit, which proves that she has actually successfully quit smoking. So, it's a really great program and I think one of the big things that motivates women is that when they blow into that monitor, they can actually see the carbon monoxide level within their body and seeing that level go down, I think, is also a big motivator.

Bill: Wow, that's really interesting. So, what is the success rate long-term after the baby is born?

Dr. Gellasch: That's a great question. We know that overall, most smoking cessation programs are actually pretty unsuccessful because it is such a challenging addiction and oftentimes smokers have friends that smoke and family members that smoke. So, they're in an environment that can often make it even more challenging to quit and stay quit. What's amazing about the Baby and Me Tobacco Free program is it does have about a 60% success rate and so what that means is that 60% of the patients that enroll and stay enrolled will quit and stay quit.

Bill: So, throughout the pregnancy, then, what does the person have to do? Do they have to come visit you once a week, once a month, or is it an at-home thing? How does it work?

Dr. Gellasch: So, great question. So, they come in for a total four visits during the pregnancy and sometimes those will be done at the same time as a routine visit, or they can be scheduled separately with the smoking cessation counselor. So, those visits are really arranged between the counselor and the patient and there's only four visits during the actual pregnancy. The majority of these visits are going to occur once the baby is born, during that postpartum time period, and that's when they're going to be earning those diaper vouchers.

Bill: Gotcha. And then, the patient gets hooked up with a counselor who gives them smoking cessation strategies, then?

Dr. Gellasch: Absolutely. So, this is a big key to the program. There is a lot of evidence out there showing that very short, brief interventions, so just five to fifteen minutes with a counselor can be extremely helpful in helping women quit and stay quit and absolutely going through strategies: what do we do when we get the urge to have a cigarette?

There's great evidence showing that if we get the urge to smoke a cigarette, if we can just make it five to ten minutes without actually going and smoking a cigarette, that urge will pass. And so, we really just have to have a coping mechanism to deal with those five to ten minutes that we're getting that urge, and then, what do we do an hour later when that urge comes back? How do we cope that? So, our counselors do a great job of helping women walk through those difficult times.

Bill: Absolutely. So, important strategies, then, coupled with the incentive, and that's why you have such good success rates with this.

Dr. Gellasch: Absolutely. Absolutely.

Bill: So, Dr. Gellasch, if someone is interested in the program, how do they sign up, or how do they learn more, or who should they contact?

Dr. Gellasch: Well, I think a good place to start is actually with the medical provider's office and there are also Department of Health locations that are offering the program, but either going to your OB provider's office and inquiring about the program or going through the local Department of Health. The other option is there is a Baby and Me Tobacco Free website, so it's www.babyandmetobaccofree.org that also lists other locations that are offering the program.

Bill: That's great information. Dr. Gellasch, thank you so much for sharing this information with us. I appreciate it greatly and hopefully, anyone listening that is pregnant and is a smoker right now, hopefully this will encourage them to join that program because it is so worthwhile.

Thank you, again, so much for your time. I appreciate it. You're listening to Rock Your Health Radio with Rochester Regional Health. For more information you can go to www.rochesterregional.com. That's www.rochesterregional.com. I'm Bill Klaproth. Thanks for listening.