University of Kentucky

An Examination of Expired Carbon Monoxide Levels and Prenatal Smoking Quit Rates in Appalachia

Institution

University of Kentucky

Abstract

Introduction: Kentucky ranks second highest in the nation (26.3% vs. 10.7%) in prenatal smoking rates, some Appalachia counties ranging from 31.1% to 53.4%. Biomarker validation is recommended to confirm prenatal smoking. Expired carbon monoxide (CO) levels are often used to confirm smoking status. Smoking behavior of the woman’s partner has been cited as a strong predictor of smoking relapse (CDC, 2006). The purpose of this study was to examine the impact of expired maternal CO levels on prenatal smoking quit rates in rural KY and examine how partner support affects quit rates. Method(s): Giving Infants and Families Tobacco Free Starts (GIFTS) was initiated in nine counties of Appalachia. In 2009, participants in Whitley County (n= 116) were provided motivational interviewing, individualized counseling, screen for social support, partner smoking, depression, domestic violence and SHS exposure; and biomarker feedback on maternal expired CO level in their health departments. CO levels were measured using the smokerlyzer + piCO monitor. Data analysis included descriptive statistics and T-tests using SAS software.Results: Prenatal CO levels ranged from 1-47 ppm with a mean level of 10.71 ppm. Eighty-two percent of women set quits dates with nearly a 25% quit rate. Seventy percent of partners smoked and women who had partners who did not smoke were significantly more likely to quit (p=.041). There was no significant difference between CO levels and quit rates, however, fewer women quit when CO levels were >9ppm. Discussion & Conclusions: The GIFTS Program and having smoke free partners increased quit rate successes and attempts.

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An Examination of Expired Carbon Monoxide Levels and Prenatal Smoking Quit Rates in Appalachia

Introduction: Kentucky ranks second highest in the nation (26.3% vs. 10.7%) in prenatal smoking rates, some Appalachia counties ranging from 31.1% to 53.4%. Biomarker validation is recommended to confirm prenatal smoking. Expired carbon monoxide (CO) levels are often used to confirm smoking status. Smoking behavior of the woman’s partner has been cited as a strong predictor of smoking relapse (CDC, 2006). The purpose of this study was to examine the impact of expired maternal CO levels on prenatal smoking quit rates in rural KY and examine how partner support affects quit rates. Method(s): Giving Infants and Families Tobacco Free Starts (GIFTS) was initiated in nine counties of Appalachia. In 2009, participants in Whitley County (n= 116) were provided motivational interviewing, individualized counseling, screen for social support, partner smoking, depression, domestic violence and SHS exposure; and biomarker feedback on maternal expired CO level in their health departments. CO levels were measured using the smokerlyzer + piCO monitor. Data analysis included descriptive statistics and T-tests using SAS software.Results: Prenatal CO levels ranged from 1-47 ppm with a mean level of 10.71 ppm. Eighty-two percent of women set quits dates with nearly a 25% quit rate. Seventy percent of partners smoked and women who had partners who did not smoke were significantly more likely to quit (p=.041). There was no significant difference between CO levels and quit rates, however, fewer women quit when CO levels were >9ppm. Discussion & Conclusions: The GIFTS Program and having smoke free partners increased quit rate successes and attempts.