Labor of Love Summit-Helping Indiana Reduce Infant Mortality

1. Labor of Love Summit-Helping Indiana Reduce Infant Mortality The Indiana Tobacco Quitline & Local Community Partner Efforts

2. Tobacco Use Burden on Indiana • 9,700 deaths/annually • More than 1 in 4 adults smoke (22%-2013) • For every death, two new youth start and 20 are living with a chronic disease • $2.08 billion in annual health care costs • $487 million in Medicaid costs • Indiana taxpayers pay $566 per household to treat tobacco-related disease • For every pack of cigarettes sold in Indiana, it spends $15.90 in health care costs related to tobacco

3. Smoking during pregnancy is associated with poor health outcomes • Twenty to thirty percent (20-30%) of the cases of low birth weight babies can be attributed to smoking. • Women who smoke during pregnancy have more than twice the risk of delivering a low birth weight baby. • Babies of mothers who smoked during pregnancy have twice the risk of SIDS than infants of nonsmoking mothers. • Women who smoke have a higher incidence of ectopic pregnancy. • Pregnant smokers also have a 30-50% higher risk of miscarriage than nonsmokers.

4. <=10% 11-20% Smoking during pregnancy 21-29% 30+% Indiana overall:16.5% County rates overall: 3.9 % to 33.9% Medicaid Members: 27.0% 2012 Indiana Natality Report

5. What is a Quitline? • Telephone-based Cessation Services • Offered Toll-free • Evidence-based • Proactive • Coaches • Highly trained in cognitive behavioral therapy • 240 hours of training • Spanish speaking competency (170 other languages) • Educated up to graduate level • Over 50% with 3+ years prior experience in counseling

6. The Program • 4 prearranged calls w/coach • 10 prearranged calls for pregnant woman (special program) • 5 prearranged calls for youth • Unlimited Web coaching • Unlimited call in privileges and access to coaches • Free 2-week NRT starter kit (uninsured, Medicaid, Medicare) • Stage-based Support Materials

7. Special Help for Pregnant Women • The Indiana Tobacco Quitline offers special services for pregnant women • 10 call protocol • Woman-centered approach: emphasizing benefits of quitting to mother and fetus • Encourages smoking partners to quit as well

8. 1. Fax Referral or Person Calls The ITQL Participant Experience 3. Professional Coach 2. Intake Specialist 3. Professional Web Coach 4. Physician RX or OTC

9. The Program WorksPractices based on 25 yrs of researchhelped hundreds of thousands of smokers quit & stay quit • Quit at personal pace • Conquer urges to smoke • Use Pharmaco so they really work • Don’t just Quit, become NON-SMOKER • Choose own Quit Date, personal Quit Coach help prepare & get ready • Learn when & where urges strike & how to cope & manage stress w/o smoking • Recommend meds right for each participant and teach how to use correctly • QUIT for good-support to make this the LAST Quit, help with weight issues

10. Something for Everyone

11. Brief Intervention ASK Do you use tobacco? ADVISE Quit tobacco products! REFER 1-800-QUIT-NOW Plus Recommend a Medication, If Appropriate

13. Conclusions • Treatment of tobacco use needs at least same attention that other chronic diseases demand • Health Care Providers are encouraged to: • Engage in effective behavioral interventions (AAR) • Optimize medication use • Know they have the most credibility w/patients • ITQL Referral/Preferred Network is one KEY component of a multi-faceted approach to decreasing Infant Mortality in Indiana.

14. Community Baby Shower Fountain and Warren Counties

15. Fountain and Warren County Demographics • No Obstetrians or Gynecologists in either county. • Nearest hospitals for deliveries are in Tippecanoe County or in the State of Illinois (Danville). • Fountain County – 2013 estimated population 16,880 • Median household income $45,919 (11.7% below poverty) 2008-2012 • Warren County – 2013 estimated population 8,415 • Median household income $51,504 (9.4% below poverty) 2008-2012 • 2012 Percent of mothers who reported smoking during pregnancy: • Fountain County 23.3% • Warren County 30.9% • Indiana State Average 16.5%

16. Morning breakout session on Lead Poisoning Prevention-included latest information on consumer products alerts and harm of lead-based paints.

17. Morning breakout session about the Indiana Safe Sleep Program-attendees of education session received a Pack n Play after demonstrating how to correctly set it up.

18. Morning break out session on Tobacco Use During Pregnancy, Exposure to Secondhand Smoke, and Thirdhand Smoke.

19. MDwise is explaining the various health plans available

20. Two displays providing information about Poison Safety and Immunizations.

21. Display representing the services available through Head Start and Early Head Start

22. Display about healthy relationships and domestic violence.

23. Display about the services offered through the Healthy Families program.

24. Display about the First Steps program.

25. Healthy lunch provided to attendees featuring Text for Baby

26. Demonstration of proper infant/child CPR techniques during lunch time

27. Information about Car Seat Safety during an afternoon break out session.

28. WIC presented information about the Benefits of Breastfeeding during an afternoon break out session.

29. Afternoon break out session about Nutrition.

30. This is why we do what we do!

31. Questions • Thank you for your participation!!!!! Brian Busching Regional Program Director/Cessation Systems Specialist Tobacco Prevention and Cessation Commission, Indiana State Department of Health bbusching@isdh.in.gov 317-234-2439 Kathy Walker Program Director Fountain/Warren Tobacco Prevention & Cessation Program 765-793-4881