Racial/Ethnic Disparities Impact the Real-World Effectiveness of a Multicomponent Maternal Smoking Cessation Program:...

Area of Science:

• Public Health
• Reproductive Health
• Addiction Medicine

Background:

• Maternal smoking negatively impacts perinatal health outcomes.
• The Comprehensive Tobacco Treatment Program (CTTP) is a large-scale state-funded initiative in San Bernardino County, California.
• Understanding real-world program effectiveness and identifying improvement variables are crucial.

Purpose of the Study:

• To evaluate the effectiveness of the Comprehensive Tobacco Treatment Program (CTTP) for pregnant smokers.
• To identify factors associated with successful smoking cessation in this population.

Main Methods:

• A retrospective cohort study of pregnant smokers enrolled in CTTP between 2012-2019.
• CTTP utilized a multicomponent behavioral cessation program including incentives, biomarker testing, feedback, and motivational interviewing.
• Abstinence was verified using cotinine levels and self-report at six months post-enrollment.

Main Results:

• 40.1% achieved prolonged, cotinine-verified 7-day abstinence during the 6-8 week enrollment period.
• The self-reported point prevalence abstinence rate (PPA) at six months was 36.7% (intention-to-treat).
• Achieving prolonged abstinence during CTTP predicted a five-fold increased likelihood of six-month PPA. Non-Hispanic ethnicities showed reduced odds of abstinence compared to Hispanics. Early cessation (first trimester) and lower initial cigarette consumption were associated with six-month PPA.

Conclusions:

• The CTTP demonstrates real-world effectiveness in maternal smoking cessation.
• Persistent racial/ethnic disparities in smoking cessation outcomes were observed, highlighting ongoing health inequities.
• Intervention strategies may need further tailoring to address ethnic disparities in smoking cessation among pregnant women.