Creating a Smoking Cessation Program

The key components of programs proven to help smokers, including pregnant smokers, quit include:

• Providing support for the quit attempt,
• Encouraging the smoker to seek out support from family and friends,
• Counseling (individual, group and telephone) to inform smokers about the dangers of smoking and the benefits of quitting, and to teach them problem solving and skill building techniques to help them quit,
• Providing pregnancy-specific self-help materials to reinforce the counseling,
• Self-help materials which offer information and exercises to help smokers cope with cravings, manage stress, change their daily habits, confront concerns about weight gain, work to avoid setbacks, and stick with their plans to quit smoking are also helpful. See the included resource list for materials specifically for pregnant smokers.
• Encouraging the use of, in some cases, nicotine replacement products (gum, patches, inhaler, nasal spray, lozenge) and medications such as bupropion SR (Zyban®, Wellbutrin®) which can be effective as part of a quit program. These drugs have not been tested for safety with pregnant women. They should only be used for heavy smokers who cannot quit with counseling alone, and for whom the potential benefits of quitting outweigh the risks of their use.

Counseling is available from physicians, state quitlines, national quitlines health agencies, nonprofit organizations, and commercial vendors. The costs of these programs vary and can range from several dollars for manuals to several hundred dollars per person for clinic programs. In general, individual counseling is more effective than
group counseling, especially for pregnant smokers. Other options and incentives include cessation counseling paid for by the company, and cash bonuses for smokers who quit smoking for one year.

For more information on smoking cessation programs, go to http://www.lungusa.org/tobacco/smkcessafac99.html

What works best for pregnant smokers?
For pregnant smokers, the U.S. Public Health Service (PHS) recommends:

• Individual counseling by a trained health care professional, along with self-help materials targeted to pregnant women. This approach has been shown to be very successful, doubling or even tripling the quit rates for pregnant smokers.
• Telephone counseling that has pregnancy-specific counseling. The Great Start Quitline (1-866-66-START) offers individually tailored counseling for pregnant women nationwide.
• More intensive treatment for pregnant smokers who are unable to quit after participating in a counseling program. The treatment could involve more intensive counseling and/or the use of quit smoking aids such as nicotine replacement.

If your company has on-site health care professionals, they can be trained to provide smoking cessation counseling and/or provide referrals for pregnant and other smokers. For more information about counseling and training opportunities, please call us at 919-843-7663.