Evidence Tools
Smoking
Introduction
This toolkit summarizes content from the Smoking in Pregnancy and Smoking in the Household Evidence Accelerator, and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.
From the MCH Block Grant Guidance. Women who smoke during pregnancy are more likely to experience a fetal death or deliver a low birth weight baby. Adverse effects of parental smoking on children have been a clinical and public health concern for decades. Children exposed to environmental tobacco smoke have an increased frequency of ear infections; acute respiratory illnesses and related hospital admissions during infancy; severe asthma and asthma-related problems; lower respiratory tract infections; and SIDS.
Goal. To decrease the number of women who smoke during pregnancy and to decrease the number of households where someone smokes.
Note. Access other related measures in this Population Domain through the Toolkits page.
Detail Sheet: Start with the MCH Block Grant Guidance
DEFINITION
Numerator:
Number of women who report smoking during pregnancy (NVSS); Number of children, ages 0 through 17, who are reported by a parent to live in a household where there is household member who smokes (NSCH)
Denominator:
Number of live births (NVSS); Number of children, ages 0 through 17 (NSCH)
Units: 100
Text: Percent
HEALTHY PEOPLE 2030 OBJECTIVE
Related to Maternal, Infant, and Child Health (MICH) Objective 10: Increase abstinence from cigarette smoking among pregnant women. (Baseline: 93.5% in 2018, Target: 95.7%); Related to Tobacco Use (TU) Objective 15: Increase smoking cessation success during pregnancy among females. (Baseline: 20.2% in 2018, Target 24.4%); Related to TU Objective 19: Reduce the proportion of children, adolescents and adults exposed to secondhand smoke. (Baseline: 25.5% in 2013-16 (age adjusted to the year 2000 standard population), Target: 17.3%)
DATA SOURCES
National Vital Statistics System (NVSS); National Survey of Children's Health (NSCH)
MCH POPULATION DOMAIN
Women/Maternal Health, Perinatal/Infant Health, Child Health, and/or Adolescent Health
MEASURE DOMAIN
Health Behavior
1. Accelerate with Evidence—Start with the Science
The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.
Evidence-based/Informed Strategies: MCHbest Database
The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.
Smoking in Pregnancy
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Evidence-Based |
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Mixed Evidence |
Emerging Evidence |
Expert Opinion |
Moderate Evidence |
Scientifically Rigorous |
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Smoking in the Household
| Evidence-Informed |
Evidence-Based |
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Mixed Evidence |
Emerging Evidence |
Expert Opinion |
Moderate Evidence |
Scientifically Rigorous |
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Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub
Emerging:
- Text Messaging Service (OK; 2016)
- Maternal Risk Assessments (OH; 2023)
Promising:
- Comprehensive Pregnancy Health Education for Teens (AZ; 2019)
- Justice Involved Pregnant and Parenting Populations (NY; 2019)
Best:
- Counseling Services (National; 2020)
- Social Marketing Campaign (VA; 2019)
2. Think Upstream with Planning Tools—Lead with the Need
The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.
Move from Need to Strategy
Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.
Planning Tools: Use these tools to move from data to action
3. Work Together with Implementation Tools—Move from Planning to Practice
The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are implementable and moveable within the realities of Title V programs and lead to improved health outcomes for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.
Additional MCH Evidence Center Resources: Access supplemental materials from the literature
- Find field-based resources focused on smoking in pregnancy and the household relevant to Title V programs in the MCH Digital Library.
- Search the Established Evidence database for peer-reviewed research articles related to strategies for reducing smoking .
- Request Technical Assistance from the MCH Evidence Center
- MCH Evidence Center Frameworks and Toolkits:
Implementation Resources: Use these field-generated resources to affect change
Practice. These tools can be used to translate evidence to action to advance this SM:
- Quitting Tobacco During Pregnancy (Alaska Native Tribal Health Consortium). This website offers resources to support smoking cessation for Alaska Native women during pregnancy.
- Preventing Exposure to Secondhand Smoke in the Home (CDC). This website describes steps parents can take to prevent secondhand smoke exposure and provides links to resources.
- Smoke-Free Environments Toolkit (AAP). This toolkit highlights the importance of smoke free environments, explains what clinicians can do to help; and provides links to resources.
Partnership. The following organizations focus efforts on supporting the reduction of smoking:
- American Academy of Pediatrics Tobacco Control and Prevention. Offers parent-education on secondhand smoke prevention and supports pediatricians in reducing children’s exposure through provider education and initiatives such as Smoke Free for Families.
- CDC’s Smoking and Tobacco Use prevention site. Includes data on health disparities, cessation guidelines for patients, professionals, and health care providers, and other resources.
Additional Resources:
- Smoking Cessation: A Report of the Surgeon General examines the effectiveness of smoking cessation tools and resources; reviews the health effects of smoking and benefits of quitting; highlights disparities in cigarette smoking and quit rates; and identifies programs, policies, and resources that can improve cessation rates and reduce secondhand smoke exposure.
- Tobacco and Nicotine Cessation During Pregnancy (American College of Obstetricians and Gynecologists) provides recommendations to help pregnant women eliminate or reduce the use of tobacco and nicotine products that can be harmful to their unborn child, including effective screening methods and evidence-based interventions that maternal health care providers can apply in practice.
References
Introductory References: From the MCH Block Grant Guidance
1National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2014.