According to the 2011 (most recent info available) Pregnancy Risk Assessment and Monitoring System (PRAMS) data from 24 states, approximately 10% of pregnant people smoked in the last three months of their pregnancy. It is quite possible that this number would be higher if all 50 states in the US were included as entire regions did not participate.

There are no surprises that smoking during pregnancy impacts the fetus as well as the pregnant parent. Some of the risks to the fetus of a parent's smoking include low birth weight, premature birth, placental complications and lower rates of effective oxygenation.

Parents who become pregnant while being a smoker may find it difficult to change this behavior, even with the knowledge that smoking harms their baby. Many of the people who smoke while pregnant may be closet smokers, meaning that they do so in secret so as not to attract the attention of others who may view their behavior as selfish and inappropriate.

As childbirth educators, you very well may have some pregnant people in your classes who are smoking, and you and others are not aware of it. This is why it is important to share information about the risks of smoking during pregnancy and how it impacts the baby. early in your class time together. I like to provide resources for support to the entire group in case any smokers are interested in quitting. Quit4Baby is an excellent resource to share. Current research indicates that this information received by text about smoking cessation during pregnancy results in more pregnant smokers stopping this behavior during their pregnancy.

A new study - "A Randomized Trial of Text Messaging for Smoking Cessation in Pregnant Women" examined the impact of enrolling in Quit4Baby, a text-based smoking cessation program for pregnant people. were already participating in the Text4Baby program.

Text4Baby is a free program that makes it easy to get important information related to pregnancy and early parenting. People who text BABY (or BEBE for Spanish) to 511411 receive free text messages three times per week, timed to their due date or their baby's birth date, through pregnancy and up until the baby's first birthday. Text4baby sends personalized messages directly to the pregnant person collated from experts in maternal-infant health. There is an associated app that can go along with the text program.

Quit4Baby sends text messages to help pregnant people quit smoking that includes tips and advice, assistance in setting a quit date, support and fun games to help get through cravings, and a tracking system to monitor success.

Quit4Baby and Text4Baby are easy to enroll in yourself with a due date in the future to see what sort of information is being disseminated, so you are familiar with the program if you are recommending it to class families and clients.

How the study was conducted

Smoking pregnant people who were already enrolled in the Text4Baby program were recruited to participate in the Quit4baby program.

497 smoking pregnant people participated and were randomly assigned to receive just Text4Baby messages (control group) or both Text4baby and Quit4Baby text messages (intervention group). While people self-identified as smokers at the time of enrollment, saliva tests were conducted at the three-month study participation mark for verification of smoking status.

Results

Participants were queried at two points in the study - one month and three months to determining their smoking status in the past seven days. 28.8% of the intervention group and 15.79% of the control group reported not smoking in the seven days prior to questioning at the one-month mark, once enrolling in the program. At the three-month mark, 35.2% of the intervention group and 22.67% of the control group reported not smoking in the seven days prior to the three-month mark. Saliva testing confirmed self-identified behavior patterns.

It appears that enrollment in the Quit4baby smoking cessation enrollment program helped more pregnant smokers stop their smoking behaviors. I think that the benefit of the program is that it is both passive and anonymous. Messages and information are delivered periodically without the participant needing to seek out information. People can enroll without identifying themselves and are obtaining information privately so that friends and family are not aware, since many of them may be not openly smoking. Regular and consistent information containing tips about stopping smoking, and the benefits to themselves and their babies provides many opportunities to hear a similar message without judgment.

Childbirth educators and others who work with pregnant families can share the Quit4Baby program with their entire class so those interested may sign up if desired. Pregnant people may not approach you to ask for direct help in quitting smoking but you can assume that there is someone in each class who is currently smoking based on current statistics. Having resources for all makes it easy for someone to take action to stop.

Do you talk about smoking and pregnancy? What is your favorite information to share?

References

Abroms, L. C., Johnson, P. R., Leavitt, L. E., Cleary, S. D., Bushar, J., Brandon, T. H., & Chiang, S. C. (2017). A Randomized Trial of Text Messaging for Smoking Cessation in Pregnant Women. American Journal of Preventive Medicine.

Pregnancy Risk Assessment Monitoring System (PRAMStat)

Tobacco Use in Pregnancy

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