Tobacco Prevention Plan takes Aim at Pregnant Women

The Lund Report


March 21, 2013 – As the Coordinated Care Organization (CCO) in Lane County, Trillium Community Health Plan is working to provide better care and better health at a lower cost to approximately 55,000 Oregon Health Plan (OHP) beneficiaries. Prevention efforts will be essential to the successful achievement of these goals.

Adult tobacco use in Lane County is high at 18%. For adults covered by OHP the rate is even higher at 34%. More troubling is that 35-40% of pregnant women on OHP use tobacco.

When this statistic was presented to Trillium’s Prevention Work Group and the Ad-Hoc Committee of the Clinical Advisory Panel (CAP), they were ready to take action. “We recognized the significance of acting now, since tobacco cessation is particularly cost effective among pregnant women,” shares Rick Kincade, MD, Clinical Advisory Panel member and representative to the Prevention Work Group. “Studies demonstrate that healthcare costs are saved for every pregnant smoker who quits. And we improve the health of the community in the process.”

The Trillium Prevention Work Group identified five strategies for tobacco cessation and prevention including intensive treatment for tobacco dependence and incentives to help pregnant women quit. “We were shocked to see how many pregnant women smoke during their pregnancy,” says Holly Jo L. Hodges, MD, Trillium. “When a pregnant woman smokes she not only endangers her health, but that of her baby.” Lane County is higher than the state average for babies with low birth weight. Tobacco use is known to be a contributor. “We recognize that if we reduce the number of pregnant women who smoke we can improve the health of both Mother and infant,” adds Hodges. “When women quit smoking in pregnancy, we will see fewer low birth weight babies and fewer physical, cognitive and behavioral problems during infancy and childhood.”

The tobacco cessation initiative for pregnant women involves intervention, counseling and treatment with incentives to quit smoking. Incentives are still being developed, but may include gift cards at a local retailer that increase in value as the woman continues to abstain from tobacco use during her pregnancy up to six weeks post-partum.

Also in the Prevention Plan is an evidence based classroom management tool, The Good Behavior Game which is designed for elementary schools that have 70% or higher of their student population enrolled in the free and reduced lunch program. Additionally, the plan calls for tobacco-free policies and a program that reminds retailers to check ID so minors won’t have access to tobacco products.

The Trillium CCO is investing more than $800,000 annually in prevention efforts that will include: tobacco cessation and prevention, depression, immunization and obesity prevention. Trillium is committing $180,000 to implement the tobacco prevention plan the first year with expected savings associated with maternal smoking to offset the investment.

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