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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
M. Olufemi Alao, PhD, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-22, Atlanta, GA 30341, 770-488-6309, mna7@cdc.gov, E. Kathleen Adams, PhD, Rollins School of Public Health, Emory University, 518 Clifton Road, N.E., Atlanta, GA 30322, and Cathy L. Melvin, PhD, MPH, Cecil G. Sheps Center for Health Services Research and Smoke-Free Families National Dissemination Office, University of North Carolina at Chapel Hill, 725 Airport Road, CB # 7590, Chapel Hill, NC 27599-7590.
INTRODUCTION: The effectiveness of smoking cessation interventions among pregnant women has been established. Brief cessation counseling of 5-15 minutes delivered by a trained provider with the provision of pregnancy-specific, self-help materials has been shown to produce quit rates that are significantly higher than those achieved through usual care. This five-step, best practice intervention is based on recommendations found in the U.S. Public Health Service’s Clinical Practice Guideline, Treating Tobacco Use and Dependence, and the American College of Obstetricians and Gynecologists (ACOG) recommends its use.
Although smoking rates among women giving birth in the US have declined steadily since 1989 to 12.3% in 1999, the rates among teenagers giving birth have increased by 5% since 1994. Further, while teen pregnancy rates have continued to decline, pregnant teens are far more likely to smoke than older mothers. The highest rate in 1999 (19 %) was for women 18-19 years of age. The Guideline makes specific recommendations for treating pregnant smokers regardless of age. Understanding the incremental costs associated with implementing these recommendations will prove useful as healthcare providers attempt to increase cessation rates among pregnant teens.
OBJECTIVE: The purpose of this study is to conduct a cost effectiveness analysis of the five-step best practice smoking cessation intervention compared to usual care for pregnant teenagers.
METHODS: To estimate the costs of the best practice intervention, we are collecting data on the resources (labor and non-labor) used to implement clinical trials conducted during Phase II of the RWJF-funded Smoke-Free Families Research Projects. Smoking-attributable expenditures for teenage mothers from CDC’s Maternal and Child Health Smoking Attributable Mortality, Morbidity and Economic Costs (MCHSAMMEC) software will be combined with cost estimates to assess the cost effectiveness of the intervention.
RESULTS: Smoking-attributable neonatal expenditures for teenage mothers in the US are estimated at $54 million. These range from about $50,000 in the District of Columbia to $4.6 million in California. Smoking prevalence and population size among teenage mothers largely drive this variation. Preliminary estimates based on ACOG’s suggested minimum time to perform each counseling step shows that the cost of the best practice intervention ranges from $4-$6 per patient per counseling session. Sessions beyond the initial one may be needed for women unwilling to undertake a quit attempt or relapsing after a quit attempt.
CONCLUSIONS: Pregnancy is an appropriate time to encourage teenage women to quit smoking.
Learning Objectives:
Keywords: Economic Analysis, Smoking Cessation
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.