Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

Sign up for MCHalert eNewsletter

Evidence Tools
MCHbest. Smoking During Pregnancy.

MCHbest Logo

Strategy. Tobacco Quitlines (Pregnancy)

Approach. Implement, advertise, or enhance QuitLine services

Return to main MCHbest page >>

Overview. Quitlines provide behavioral counseling to tobacco users who want to quit. Cessation specialists schedule follow-up calls after their first contact with the tobacco user. Some quitlines are proactive (meaning the specialist initiates the follow-up), while others are reactive (meaning the tobacco user is responsible for making any future contact). Some quitlines provide additional interventions, which may include mailed materials, web-based support, text messaging, or tobacco cessation medications.[1] Many quitlines offer services in multiple languages.[2]

Evidence. Scientifically Rigorous Evidence. Strategies with this rating are most likely to be effective...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Quitline referral and enrollment data
  • Reach and engagement data from advertising and outreach activities
  • Participant feedback on quitline services and referral experience

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of promotional campaigns launched to advertise quitline services to pregnant women who smoke. (Measures outreach efforts)
  • Number of prenatal care providers trained on effectively referring patients to the quitline. (Measures healthcare system engagement)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of quitline staff certified as tobacco treatment specialists. (Measures quality of service delivery)
  • Percent of quitline services available in languages other than English. (Measures usability)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of protocols established for warm hand-offs from the quitline to local in-person cessation services for pregnant women. (Measures care coordination)
  • Number of OB/GYN practices that implement an electronic referral system to the quitline as part of standard care. (Measures integration into healthcare system)
  • Number of pregnant women who make a quit attempt with quitline support that lasts 24 hours for more. (Measures initial behavior change)
  • Number of individuals who accessed quitline services during pregnancy and engage in postpartum relapse prevention counseling. (Measures continuity of care)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of quitline marketing campaigns designed to resonate with pregnant women from communities experiencing tobacco-related challenges. (Measures tailored outreach)
  • Percent of quitline coaches who receive training to effectively serve pregnant callers from various backgrounds. (Measures workforce preparation for access to services)
  • Percent decrease in smoking prevalence during pregnancy among callers from groups with high smoking rates after quitline implementation. (Measures impact on reducing gaps in care)
  • Percent reduction in smoking-attributable adverse birth outcomes in regions with high quitline utilization by pregnant women. (Measures impact on health outcomes)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 The Guide to Community Preventive Services (The Community Guide). Tobacco.

2 North American Quitline Consortium (NAQC). Promoting evidence based quitline services across diverse communities in North America. United States profiles.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.