Top Strategies for Promoting Smoking Cessation Pregnancy Programs

Top Strategies for Promoting Smoking Cessation Pregnancy Programs

Promoting smoking cessation pregnancy programs can be a complex issue.


For health plans, healthcare systems, and employers, it can be difficult to know if a pregnant woman is using tobacco unless she discloses the addiction.

Fortunately, there are still ways you can help.

Impact of Smoking on Pregnancies

Smoking cigarettes while pregnant is harmful to both mother and child. Tobacco use during pregnancy is linked to poor health outcomes, including:

Smoking during pregnancy is also costly. The total cost of neonatal healthcare in the U.S. due to smoking during pregnancy is an estimated $366 million annually. Preventing just 1 smoking-related low birth weight baby can save about $40,000 in healthcare expenditures.

Preventing just 1 smoking-related low birth weight baby can save about $40,000 in healthcare expenditures.

Who is Most Likely to Smoke While Pregnant

In our online EX Community of current and former tobacco users, pregnant women share the devastating effects of this addiction, including this woman who posted:

“I am 9 weeks pregnant and I am addicted to cigarettes and struggling to quit. Every day I feel so ashamed of myself. I’m so afraid I’ve harmed my baby. I feel I don’t deserve to be a mother and that I am a bad person.

That community member is far from alone, although she might feel that way.

According to the CDC, the average smoking rate among pregnant women is 7.2%. However, the rate is higher than that in 31 states. The highest smoking rate during pregnancy is in West Virginia (25.1%), followed by Kentucky (18.4%), Montana (16.5%), Vermont (15.5%), and Missouri (15.3%).

U.S. map showing prevalence of maternal smoking at any time during pregnancy

What Works to Engage Pregnant Smokers in Quitting?

Pregnancy can be a powerful motivator to quit. An estimated 55% of pregnant smokers quit by the last three months of pregnancy.

And pregnant women who quit smoking during the first trimester can deliver infants that are of comparable weight and height to those of non-smoking women.

Here are a couple of approaches to promoting smoking cessation pregnancy programs that can make a difference, and address this population in a respectful, caring, and meaningful way.

Use the Right Messaging

As the quote from an EX community member above demonstrates, pregnant women who use tobacco already feel shame. As a result, many will hide their tobacco use from others rather than face harsh judgment.

To increase confidence in quitting, messaging in promotions needs to be supportive rather than scolding. It can also help to use nonjudgmental language that ideally focuses more on gain-framed messages when quitting (vs. loss-framed messages), according to a study published in Addictive Behaviors Reports.

For example, 3 messages this study cited as rating highest for effectiveness include: “When you quit smoking, you take control of your own health and the health of your baby”; “Quitting smoking can prevent harm to you and your baby”; and “There are lifelong benefits to children growing up in a smoke-free environment.”

Be Creative with Materials

Including messaging in standard promotions, such as through social posts and posters/flyers, are important, but it’s also crucial to use other channels, too. When it comes to engaging people to action, one touch point is rarely enough.

For example, for employers, other means of promotions might include:

Mirror clings in bathrooms

Yard signs leading up to entrances

Garbage can wraps

Wallet cards that can be grabbed discreetly in breakrooms

And for health plans and community healthcare systems, this could also mean promoting smoking cessation through:

Asking pregnant women whether they have cut back on smoking since they found out they were pregnant (rather than just asking about current smoking) helps reduce the stigma around smoking and encourages more honest answers.

Flyers and materials for care managers with Medicaid health plans to use with members

Creating a drive-thru “baby shower” where new moms can easily pick up information on self-care, including tobacco cessation

Presentations to stakeholders to educate them about the availability of this resource

Outside banners thoughtfully placed in highly visible locations

Cost-effective digital billboards placed along high-traffic freeways

Radio ads

Digital advertising trucks driving through key areas where target populations live

Widely promoting your quit-tobacco program can help not only those employees or members who are pregnant, but also family members or spouses who may be looking for resources like these.

See how the EX Program partnered with Montgomery County ADAMHS to build a creative and effective multi-touch campaign that drove registrations.

Promote Easy-Access, Evidence-Based, Tailored Support

At the EX Program, we offer digital, people-powered resources that are specifically tailored to pregnant women and new moms. These resources include expert support through live chat with our EX Coaches, who can select and ship quitting medications (if appropriate).

We also provide expert online content from Mayo Clinic that answers frequently asked questions, such as the best methods to quit while pregnant or the fear of weight gain when quitting.

We offer pregnant women who smoke a customized text messaging intervention, too. This library of messages continues up to 12 months after delivery.

And we have community groups just for these individuals so they can connect with one another. Our online EX Community gives pregnant women who use tobacco a safe space for encouragement and social support, with no judgment.

Contact us today to learn more about how we can help you give pregnant women and new moms the right tools to quit tobacco.

Jessie Saul, Ph.D.
Jessie Saul, Ph.D.

Director, Strategic Insights

Dr. Jessie Saul brings 19 years of experience in research, program evaluation, and strategic implementation around tobacco cessation. She applies this deep understanding to improve EX Program performance and reduce tobacco use among populations. She earned her Ph.D. in Science and Technology Studies from Cornell University.

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