QuitLinks Focus On Moms and Moms-To-Be
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| Jennifer Civello |
"Quitting smoking is so easy," she said. "What's hard is staying quit. Smoking is far more entrenched in daily living than you can imagine."
"We Smoked"
Civello, 30, is the REACH Community Health Foundation tobacco treatment program coordinator, and a former smoker. And like many Berkshire region smokers, the habit started during the middle school years, she said.
"We smoked," Civello said of her pre-teen and teen years. "My girlfriends and I probably started smoking in the sixth or seventh grade, stealing cigarettes from our parents. By high school, we were all smokers."
A recent study showed that during 2005, 28 percent of the women who gave birth at the North Adams Regional Hospital were smokers. That beat the state percentage by 21 percent, and raised concerns among local health care professionals.
Many studies link tobacco use during pregnancy with low birth weight babies, and moms-to-be who smoke are usually moms who smoke.
Second-hand smoke has been directly linked to asthma, a higher incidence of childhood colds, and an increased rate of ear infections in children.
And it's not a healthy habit for adults. Smoking is a cause of cancers, heart disease, lung disease, and a host of other health complications.
An Alarming Number
"That 28 percent rate was pretty alarming," said Civello.
The state Department of Public Health awarded only two grants state-wide for tobacco treatment programs aimed at women in their child-bearing years, and both grants went to the Berkshires.
REACH received $37,500 for Fiscal Year 2007 and expects to receive $50,000 in grant funds for FY 2008, Civello said. There is opportunity to reapply for the funds over the next three-and-a-half years, she noted. The Berkshire Medical Center also received a grant from the DPH, Civello said.
QuitLinks, the REACH program, is a pilot program with a goal of cutting the smoking rate for women of child-bearing age.
"We don't have a specific number in mind," Civello said. "28 percent of all women giving birth is a huge number, so any improvement is considered good."
Since many people begin smoking as adolescents, Civello cautioned against stereotyping young people who may become smokers.
"We were the kids making the honor roll, the kids playing sports," she said. "We weren't the kids who were stereotypically running off to smoke in the bathroom."
Civello said she was athletic as a high school student, and played junior varsity soccer and was basketball season varsity cheerleader.
Data Collection and AARP
QuitLinks functions via two primary actions. Data collection occurs through questionnaires available at the pediatric offices of specific area pediatricians, obstetricians and gynecologists, and the Northern Berkshire Women's, Infants, and Children nutrition program. The questionnaires ask about patient smoking habits, household member smoking habits, and if smokers are offered a referral to a smoking treatment program.
The questionnaires use the first three initials of a patient's last name and a first name first initial. Civello collects the forms weekly, records the data and submits the information to the DPH, which ten interprets the information. December was the first month of the process, she said.
The protocol is an abbreviated version of what's called "the Five A's," Civello said.
"The providers are using a version of 'ask,' 'advise,'refer' and 'prescribe,' if appropriate, nicotine patches, or pill therapy to help someone quit."
Patients may fill out contact cards available at the participating entities. The cards are placed into a box and Civello retrieves cards and makes direct contact with those who have expressed an interest in the program, she said.
She'll Go To You
"I have received 40 cards and I am counseling 10 people, two of whom have quit," she said. "I think 40 referrals in three-and-a-half weeks is pretty good."
Civello emphasized that the program is free and that she does accept "self-referrals." Civello also works with the Healthy Families and Healthy Start Partnership initiatives.
She meets in person with Northern Berkshire women of child-bearing age who want to work the QuitLinks program.
"I am very flexible," she said. "I meet with people in my office, I will meet with people in their home or out in the community. I will meet with them where they need me to meet with them."
Most people are aware of the health risks of smoking and many have some desire to stop their habit. But for a great many smokers, the scales of success are weighted against them. Just meeting with Civello may be challenging for those who face transportation issues and a great many female smokers are faced with financial and family challenges.
"Often, these folks have an awful lot of stress in their lives," Civello said.
First meetings often involve discussing the smoking history and any previous attempts to quit. Civello asks people why they believe previous attempts did not succeed. The idea is to develop new coping mechanisms so that smokers who want to quit have new stress-tackling strategies, she said.
Motivation And Relapse
Relapse is common.
Civello said that she was 23 years old when she learned that her 45-year-old mother, a smoker, was diagnosed with lung cancer. Her mother was told that she would likely survive for six to 12 months, and she died eight months after being diagnosed, Civello said.
"That was good motivation for me to quit but I relapsed after that, several times," she said.
Day By Day
Civello said that she advocates a day-by-day smoking reduction plan. On the first day, a smoker may smoke one cigarette per waking hour, and then reduce the amount smoked by three cigarettes each day following. By the seventh day, smoking should be eliminated from the routine, she said.
There are those who find that they drastically reduce cigarette smoking but can't get away from one or two cigarettes a day, Civello said.
"And that's when we start really talking about coping skills," she said. "People don't always realize how much smoking permeates their lives."
For many women, the quit catalysts are children's health or financial concerns related to smoking costs. A good first step is filling out the form, Civello said.
"In order for someone to take the time to fill out the form, they have to be motivated," she said. "I hope that I'll have some real success with this."
There is no income criteria for the program.
Women who are interested in the QuitLinks program may call Civello at 413-664-5567 or contact her a a jcivello@nbhealth.org e-mail address.
