Why it matters:

Smoking during pregnancy can have a negative impact on the health of women, infants, and children by increasing the risk of fertility problems and pregnancy complications. It can also increase the risk for preterm birth, low birth weight, and sudden infant death syndrome - some of the leading and most preventable causes of infant mortality. Quitting smoking prior to and any time during pregnancy carries benefits, especially considering the many additional risks of postnatal tobacco smoke exposure for infants and children, including respiratory infections, ear infections, and asthma.

Current trend:

Vermont has a stable percentage of WIC enrolled women who quit smoking during pregnancy.For the 2012-2014 period, 22.4% of WIC-enrolled women quit smoking during pregnancy.

Factors contributing to smoking among WIC-enrolled women include:

• smoking may be a mechanism to cope with boredom, relieve stress and as a companion to alcohol and caffeine
• educational materials may not be culturally appropriate to this group
• intense marketing to this population by the tobacco industry
• smoking may be considered the norm by family and peer groups
• adverse childhood experiences these women may have faced during early childhood are linked to a higher risk of unhealthy behaviors.

Copley Hospital

802Quits

Children’s Integrated Services

Area health care providers

Social service organizations

Quitting smoking is difficult, and it may take five to seven attempts before a smoker is successful. Evidence-based cessation programs offered through individual, group, or on-line counseling have demonstrated some effectiveness.Counseling and support by the woman’s health care provider can be a strong motivator to quit. Prevention efforts that target youth before they begin smoking may offer the most promise.

Continue education focus on the effects of smoking during home visits.

Create standard interview structure for WIC visits so that all practitioners use motivational interviewing with standardized interview questions and consistent follow up.

Trend data for district referrals, looking at who accepts or refuses referrals and follow-up with clients to see if additional support is needed.

Seek recommendations for strategies from the Department of Health.

Collaborate with other agencies that share WIC clients, such as Reach-Up and Head Start.