National effort to help pregnant women protect themselves, their infants by stopping smoking

October 15, 2000

CHAPEL HILL - The Robert Wood Johnson Foundation of Princeton, N.J., has awarded $1.2 million to the University of North Carolina at Chapel Hill to combat one of the most stubborn problems affecting the health of mothers and their unborn children - how to quit smoking during pregnancy.

The money will fund a new program at UNC-CH's Cecil G. Sheps Center for Health Services Research known as the Smoke-Free Families National Dissemination Office.

"In 1993, the Robert Wood Johnson Foundation started the Smoke-Free Families: Innovations to Stop Smoking During and Beyond Pregnancy project at the University of Alabama at Birmingham," said principal investigator Dr. Cathy L. Melvin. "Its purpose was to identify, through a series of clinical studies, the most effective way to help pregnant smokers quit using tobacco during pregnancy and after their babies were born."

Melvin directs the Child Health Services Program at the Sheps Center and the new Smoke-Free Families office.

"Now the National Dissemination Office will translate previous findings into practice," she said. "We will disseminate information on current best practices in treating tobacco use in pregnancy, synthesize results of future trials and conduct research on how to integrate the most successful ways of getting women to stop smoking into clinical settings such as clinics and doctors' offices. Our job is to make sure that every pregnant woman is asked about her use of tobacco and, if she is a smoker, to assure that she receives the best possible evidence-based intervention."

A steering committee of U.S. research and service organizations will help Melvin and her colleagues plan and carry out future collaborative work, she said.

"We are excited about this opportunity to affect what has been one of the most intractable maternal and child health problems of our time, low birth weight," Melvin said. "We think we have an opportunity to improve women's long-term health if they quit during pregnancy and stay quit and to help infants at the same time. The office also brings a lot of resources to the university."

"We are very fortunate to have this project in the Sheps Center," said Dr. Gordon H. DeFriese, director of the center. "It gives us an opportunity to contribute to this important set of issues. But, more importantly, we have been able to gain Dr. Cathy Melvin, one of the nation's leading maternal and child health researchers. She could have chosen any university in the country as the site for this important project. She chose the Sheps Center at UNC-Chapel Hill."

One of the largest efforts will be to increase the number of health-care providers such as doctors who counsel pregnant women about smoking and help them to quit through a five-step program proven to be effective. Training health-care providers to promote quitting tobacco use will be a major emphasis. Full use of the program should increase cessation rates by between 30 percent and 70 percent, research suggests.

"We will ask pregnant women about their use of tobacco and if they say that they've quit, we'll say 'great,' stress the importance of the decision for them and their babies and strongly encourage them to not begin smoking again," Melvin said. "If they smoke, we'll advise them of the risks of continued smoking and the benefits of quitting."

If smokers are willing to try to quit, doctors, nurses and others will show them the most effective ways of being successful, in part by arranging strong social support if possible from family members, friends and co-workers and providing written self-help materials. Women trying to quit will also be contacted periodically to offer further encouragement and support, even if they have not yet succeeded.
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Among national groups supporting the new office at UNC-CH are the Agency for Healthcare Research and Quality, the American Association of Health Plans, the American College of Obstetricians and Gynecologists, the Health Resources and Services Administration, the Centers for Disease Control and Prevention, and the Association of Maternal and Child Health Programs.

Note: Melvin can be reached at (919) 843-7663.

Sheps Center Contact: Carolyn Busse, 966-3847
News Contact: David Williamson, 962-8596

University of North Carolina at Chapel Hill

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