Objective To test the feasibility, acceptability, and efficacy of Get Fit and Quit (GFAQ), a community engaged, holistic, tobacco treatment program for women of childbearing age in a residential, substance use disorder (SUD), treatment facility. Design A quasi-experimental, one group, longitudinal design. Setting A local Young Men’s Christian Association (YMCA) location. Participants Twenty-three women of childbearing age were enrolled in the study. Nearly all (21 of 23) participants were White, and most were non-partnered and unemployed. More than one-third of participants had more than high school educations, and five (22%) were pregnant at enrollment. Methods The program was conducted in 10 sessions over six months. For each 90-minute session, approximately 45 minutes were dedicated to smoking cessation and 45 minutes were dedicated to group physical activity. Means and 95% confidence intervals were used to summarize nicotine dependence, expired carbon monoxide, urine cotinine, and exercise self-efficacy at baseline, 5-week, 8-week, and 6-month assessments. Cigarettes smoked per day were summarized using medians and interquartile ranges over time. Program satisfaction and regular exercise were presented as percentages with 95% confidence intervals. Results Of the 23 women who enrolled in GFAQ, seven (30%) completed the program. Compared to baseline, participants who completed GFAQ had lower nicotine dependence and smoked fewer cigarettes per day. Additionally, at five weeks, more GFAQ participants exercised regularly (64%) compared to baseline (14%). Most participants viewed the program favorably. Conclusions Smoking among women of childbearing age with SUDs is an important public health issue. GFAQ is a promising intervention for tobacco treatment for this high-risk population, although the number of initial participants who completed the program was low.

Background Opioid use during pregnancy is a significant public health issue. The standard of care for treating opioid use disorder during pregnancy includes medications for opioid disorder (MOUD). However, tobacco use often goes unaddressed among pregnant women on MOUD. In 2018, our team received a National Institute on Drug Abuse (NIDA) funded R34 to conduct a three year-randomized trial to test the feasibility of a novel tobacco intervention for pregnant women receiving MOUD. Aims The aims of this study are: (1) to determine the impact of the B-EPIC intervention on maternal tobacco use and stage of change; (2) to determine the impact of B-EPIC on tobacco-related maternal and infant health outcomes including gestational age at birth, birthweight, NAS diagnosis and severity, and number of ear and respiratory infections during the first six months; (3) to compare healthcare utilization and costs incurred by pregnant patients that receive the B-EPIC intervention versus TAU. Methods We plan to enroll 100 pregnant women on MOUD for this randomized controlled trial (B-EPIC intervention n = 50 and treatment as usual n = 50). A major strength of this study is its wide range of health and economic outcomes assessed on mother, neonate and the infant. Conclusions Despite the very high rates of smoking among pregnant women with OUD, there are few tobacco treatment interventions that have been tailored for this high - risk population. The overall goal of this study is to move towards a tobacco treatment standard for pregnant women receiving treatment for OUD.

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