May 18, 2014
Last week, the N.C. Child Fatality Task Force released its 2014 Report to the General Assembly. The report detailed the remarkable progress that has been made in reducing child deaths over the past 23 years and contained a variety of recommendations aimed at further protecting our children.
Because two-thirds of all child deaths are to babies before their first birthdays, the task force has a number of recommendations to promote healthy birth outcomes. One of the key recommendations is to fund You Quit Two Quit, an evidence-based program that will help pregnant women quit smoking.
According to the Campaign for Tobacco Free Kids, nearly 749,000 North Carolina women (1 out of every 5 women of childbearing age) smoke, and an estimated 4,600 women die every year from smoking-related disease. Sadly, North Carolina ranks 36th in the nation for the number of women who smoke. And alarmingly 10 percent of our state’s pregnant women use tobacco. More than 1 in 10 babies are born to North Carolina women who used tobacco during pregnancy – and in some counties as many as a third of babies are born to women who smoke.
This is a tragedy for North Carolina as babies exposed to smoking are more likely to be born prematurely, have a low birth weight and have certain birth defects. Smoking and the related complications increase the risks of pregnancy loss, bleeding from placental problems and even newborn death. Babies exposed to tobacco smoke also have increased risk of asthma. There is also a huge economic toll from tobacco use. Each year our state spends close to $1.5 billion to treat female smokers.
We also know the benefits of quitting tobacco use – both for mom and baby. Pregnant women who quit smoking demonstrate a 17 percent reduction in the number of low birth weight babies, a 14 percent decrease in premature births and an average increase in birth weight of 54 grams. The N.C. State Center for Health Statistics estimates that if no pregnant women smoked, infant mortality would decrease by at least 10 percent in North Carolina.
All these positive things for the health of babies and the health of our state could come from the act of moms-to-be quitting tobacco use – but we all know that quitting is not simple. Virtually every pregnant woman wants to stop smoking or using tobacco products, but tobacco is highly addictive, and it takes more than a strong will to stop, even if a woman is pregnant. Pregnant women need their physicians’ help to quit, and studies show that brief counseling interventions increase cessation rates among pregnant smokers from 30 to 70 percent. They also need the help of partners, family and friends in the goal to quit smoking.
The You Quit Two Quit Program can provide much of that help. YQ2Q, which was developed at the UNC Center for Maternal and Infant Health, is a training and technical support program aimed at assisting health care providers to help their pregnant patients quit tobacco use. YQ2Q has successfully conducted two demonstration projects showing that incorporating the evidence-based 5As (the first A is ASK your patient if she smokes) makes a substantial difference in increasing the number of women who quit smoking during pregnancy and stay smoke-free after their baby is born. The provider practices that participated in the YQ2Q demonstration programs gained a valuable and effective tool for helping their patients quit smoking.
We know that YQ2Q works; now we need to take it statewide. This effective and successful intervention should be made available to all health care providers who care for women and their families so they can more effectively help their patients quit tobacco use. As part of its Healthy Baby Bundle of programs aimed at reducing infant mortality, the N.C. Child Fatality Task Force recommended that the 2014 budget include a $200,000 appropriation to give providers and women in all 100 counties access to this evidence-based cessation program.
In these lean budget times, we understand that $200,000 is a lot of money, but given the emotional toll and costs of tobacco on women’s and infants’ health, this investment should clearly offer an excellent return on investment in health costs averted and lives saved. We hope our legislators will agree.