Indiana Medical Error Reporting System

Indiana Medical Error Reporting System

Campaign To Reduce
Smoking In Young Women
In Bartholomew County
QUIT NOW
ASK HOW
376-5033
Presented by: Peggy Voelz,
Coordinator of Tobacco Prevention Programs
For Bartholomew County
Overview
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Indiana’s and Bartholomew
County’s Toll
Complications during
Pregnancy
Health of Unborn Child and
Young Child
Bartholomew County’s
Approach to the Problem
Successes, lessons learned….the
ongoing story
Indiana’s Toll...babies are
smoking and not by choice!
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18% of women in Indiana smoked during
pregnancy
17% in Bartholomew County
64 of Indiana’s 92 counties have a smoking
during pregnancy rate higher than the Indiana
average
Indiana ranks 2nd in the nation for smoking!
39% of 18-24 year olds smoke in Indiana
Women’s Fertility
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More difficulty becoming pregnant
Higher risk of never becoming pregnant
Greater chance of complications during
pregnancy
Premature birth
Low Birth Weight (LBW) Infants
Stillbirth and Infant Mortality
Health of Unborn Child
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Low Birth Weight-babies of smoking
mothers often weigh less than 5.5
pounds.
LBW babies have less muscle mass
and more fat.
Nicotine constricts blood vessels in
the umbilical cord and womb thus
reducing the amount of oxygen and
blood to the baby.
Some association with increased risk
of oral clefts and infantile colic.
Health of Infants &
Young Children
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Secondhand smoke has been classified by
the Environmental Protection Agency
(EPA) as a Class A carcinogen, known to
cause cancer in humans.
SIDS-Sudden Infant Death Syndrome.
Infants exposed to secondhand smoke
after birth have double the risk. Babies
of mothers who smoke before and after
birth are 3 to 4 times more likely to die
from SIDS.
Infants & Young Children
(continued)
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In the first two years of life, children
exposed to secondhand smoke (SHS)
have more than a 50% increased risk of
bronchitis and pneumonia.
Infants and young children exposed to
SHS have higher rates of asthma,
increased severity of asthma attacks, ear
infections, and respiratory diseases.
SHS can reduce the amount of Vitamin
C, a disease fighting nutrient in children.
Additional Findings
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The Surgeon General Reports: There is NO
risk free level of exposure to secondhand smoke.
Secondhand smoke at home or work increase the
risk of developing heart disease by 25 to 30
percent and lung cancer by 20 to 30 percent.
Breastfeeding-research has shown that smoking
may contribute to inadequate breast milk
production..
Cervical Cancer-women who smoke have up to 4
times higher risk of developing cervical cancer.
Bartholomew County’s
Healthy Communities Initiative –
Sustained Success Through Local
Community Partnerships
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Passion
Commitment
Sustainability
Results
Tobacco Awareness Action Team, a Healthy
Communities Initiative since 1995…promoting
healthy lifestyles
Community Smoking/Pregnancy
Task Force
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Summer of 2006 gathered key partners together to
brainstorm solutions including:
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Volunteers in Medicine Free Health Clinic
Bartholomew County Health Department
WIC
OB/GYN offices
Young Mothers Educational Development (YMED)
March of Dimes
Tobacco Awareness Action Team
Caring Parent Mentoring Program
Pregnancy Care Center
Action Items Generated by
Brainstorming Session
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Medical practices/OB offices want training to
counsel patients
Other agencies who interact with pregnant
women also want training
Tools to use in their conversations with pregnant
women
A public awareness campaign
Coordinated effort by the Tobacco Awareness
Action Team
Educate – Every Chance
You Can Get
The 3 C’s Campaign:
Consistent
Message – Quit Now,
Ask How!
Cover
The Community:
Publications (newspaper, editorials,
Wellness brochures, websites, etc.)
Convince
Key Leaders: hospital
leadership, legislators, community
leaders
First Steps…
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In celebration of the Great
American Smoke-out
Something bold – buttons and
posters
Get the hospital on board.
Mass distribution to all medical
offices/dental offices
Distribution to other agencies
QU T NOW
ASK HOW
376-5033
Ask a patient –Do you smoke?
Assess – Would you like to talk
about quitting?
Assist – Call 376-5033 for
information about Tobacco
Cessation Clinics and quitting.
QU T NOW
ASK HOW?
376-5033
PLEASE WEAR A BUTTON
Ask a patient –Do you smoke?
Assess – Would you like to talk about quitting?
Assist – Call 376-5033 for information about
Tobacco Cessation Clinics.
Collaboration of Educational
Opportunities with
March of Dimes
Columbus Regional Hospital- CME
Smoking Cessation Interventions For
Professionals Providing Healthcare To
Women And Their Families
Phillip N. Eskew, Jr., MD
St. Vincent Hospital
Wednesday, January 31st, 2007
12:00 noon to 1:00 pm – Kroot Auditorium
More Intensive Tobacco
Cessation Counseling Training
Facilitate
the change by making it easy to
participate in the trainings
Offer intensive training to all medical
offices and other agencies who work with
pregnant women.
Continuous feedback and follow-up with
participants…what else do they need?
A Clinician's Guide To Helping
Pregnant Women Quit Smoking
Course Objectives
At the conclusion of this course, participants
should be able to:
Outline key components of state-of-the-art
tobacco use cessation
Identify
the 3 basic components of nicotine
addiction
Summarize basic assessment tools for
diagnosis of tobacco dependency
Describe
current drug therapy options,
indication, and contraindications
Describe behavioral modification techniques
5 A’s Approach to
Smoking Cessation
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A 5-step smoking
intervention proven effective
for pregnant women
Consistent with strategies
developed by the National
Cancer Institute, the
American Medical
Association, and others
Adapted for pregnant
women by ACOG
Smoking Cessation During
Pregnancy
Evidence-based brief counseling is more
effective than simple advice to quit
 A trained clinician can improve cessation
rates by 30% - 70%
 Most effective for light to moderate
smokers (< 20 cigarettes/day)
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Melvin CL, et al. Recommended cessation counseling for pregnant women who
smoke: a review of the evidence. Tob Control 2000;9(suppl III):iii80–iii84.
Fiore MC, et al. Treating Tobacco Use and Dependence. Clinical Practice Guideline.
Rockville, MD: US Department of Health and Human Services. Public Health
Service. June 2000
The 5 A’s
1. Ask about tobacco
use
2. Advise to
quit
3. Assess willingness to make a quit
attempt
4. Assist in quit attempt
5. Arrange follow-up
© 2002 The American College of Obstetricians and Gynecologists
Assist In The Implementation Of
Smoking Cessation Protocol
Step 1. Develop administrative commitment
Step 2. Involve staff early
Step 3. Assign one coordinator
Step 4. Provide training
Step 5. Adapt procedures to your setting
Step 6. Monitor and provide feedback
Power of Intervention
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One-third to one-half of smokers
will die from the habit. Of the 32
million smokers who want to quit,
10 to 16 million will die from
smoking.
If the 2.5 percent cessation rate
were increased to 10 percent, 2.4
million additional lives would be
saved.
If the cessation rate rose to 15
percent, 4 million additional lives
would be saved.
Community Cessation Clinics
and In-house Tobacco
Counseling Program
On-going
cessation clinics since 1999
Collaboration with the local health
department since 2004 to offer free
patches
Columbus Regional Hospital SAK
pack in-house tobacco counseling
program since 2004
Quit Lines– A Well-Kept Secret
Quit Lines provide smokers with free cessation
services including counseling, self-help kits, and
cessation information.
 They work. With repeat sessions, they can help
smokers quit at the rate of 27 percent
(12-month abstinence rate)
in one California study.
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Programs Demonstrate,
Policy Perpetuates
Recent successful educational
campaign to raise cigarette tax by 44
cents will save lives and result in:
 5-Year healthcare savings from fewer
smoking-affected pregnancies & births:
$12.1 million
 Number of smoking-affected births
avoided over next five years: 7,100
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Policy: Smoke-free Workplace
Ordinances Save Lives, Too!
Major cause of respiratory disease, sudden infant
death syndrome, ear infections, and asthma attacks.
There is no safe level of exposure to firsthand
tobacco smoke or secondhand tobacco smoke.
Good Smoke-free Workplace Policies will:
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Decreases
the SHS exposure to unborn baby and
mother
Decreases SHS exposure to newborn babies
Expose The Truth…Women
Are Being Exploited!
Tobacco Industry’s Newest Scam:
 Camel No. 9, has a name that evokes a
women’s fragrance like Chanel No. 19, as
well as a song about romance, “Love
Potion No. 9.”
Camel No. 9, a hot-pink fuchsia and a
minty-green teal; its slogan, “Light and
luscious;” and flowers surround the packs
in magazine ads.
Bartholomew County’s 2007-2009
Work Plan In Progress
Additional
5 A’s Trainings to ensure that we
cover the community
Assist in the implementation of consistent
counseling procedures within each office
Specific teaching aids to each medical office
DVD for waiting rooms/patient rooms
Additionally…
“Spokesperson”
nurse or other professional to
spread the word through media, radio, internet
“Testimonials” from past quitters for ads, press
releases
Campaign to expand our ordinance to include
bars/private clubs in Columbus
And finally…. Results from surveys
conducted by ITPC that show a decline in
smoking status of pregnant women!
Contact – Peggy Voelz
[email protected]