Perinatal Navigator Approach to Smoking Cessation for Women With Prevalent Opioid Dependence

Abstract

Women who smoke during pregnancy face psychosocial barriers to cessation, and women with opioid use disorder (OUD) face amplified barriers. We pilot tested a Perinatal Wellness Navigator (PWN) program for a group of high-risk perinatal women ( N = 50; n = 42 with OUD) that consisted of (a) one-on-one tobacco treatment, (b) comprehensive assessment of cessation barriers, and (c) linkage to clinical/social services. Outcome measures were assessed at baseline and postintervention. Participants smoked 10 fewer cigarettes per day ( p = .05) at postintervention and were less dependent on nicotine ( p < .01). Mean postnatal depression scores ( p = .03) and perceived stress ( p = .03) decreased postintervention. Participants received at least one referral at baseline ( n = 106 total), and 10 participants received an additional 18 referrals at postintervention to address cessation barriers. The PWN program was minimally effective in promoting total tobacco abstinence in a high-risk group of perinatal women, but participants experienced reductions in cigarettes smoked per day, nicotine dependence, stress, and depression.

Smoking cessation interventions for pregnant women attending treatment for substance use disorders: A systematic review

“…Five studies targeted women receiving OAT [16–18,24,26] and two targeted those in treatment for general drug dependence [20,25]. .…”

“…The initial search returned over 2000 articles, of which six were included in the final review [ 16 , 17 , 18 , 20 , 24 , 25 ] including four previously identified [ 16 , 17 , 18 , 20 ]. The unpublished results of an additional study came from an expert contact [ 26 ].…”

“…All studies were conducted in the United States (US) between 1996 and 2019, incorporating 875 women. They comprised a variety of methodological designs: two randomized controlled trials (RCTs) [ 16 , 17 ]; two single‐arm pilot studies [ 24 , 26 ]; two program evaluations [ 20 , 25 ] and one causal comparative study [ 18 ].…”

“…Bennett et al evaluated a group-counselling program in pregnant and postpartum women receiving OAT (n = 50)[24]. The program produced significant reductions in past 30-day CPD.…”

Tobacco and Social Justice

“…In addition to addressing heterogeneity, novel intervention approaches are identified in this special issue. Fallin-Bennett et al (2019) used an innovative, personalized, multidimensional approach to helping women in the perinatal period quit smoking. Williams, McCall, Joshua, Looney, and Tingen (2019) used community health workers to increase access to lung cancer screening for people in low-resourced communities.…”