Perinatal Tobacco Treatment (C3819): KORE (SOR II) Tobacco Cessation (State)

K-PACT ABSRACT Women with substance use disorders, particularly those with opioid dependence, are highly vulnerable to cigarette smoking during the perinatal period. Pregnant opioid dependent patients seeking treatment, including medication-for opioid use disorder (MOUD) have high rates of smoking, ranging from 88% to 95%. Illicit opioid use magnifies these tobacco-related adverse pregnancy outcomes including a 6-fold greater risk for intrauterine growth restriction, third trimester vaginal bleeding, preterm delivery, and neonatal abstinence syndrome (NAS). Further with the emergence of novel tobacco products, including Electronic Nicotine Delivery Systems (ENDS) risk of co-use (tobacco to opioids) continues among an already high risk population. Prenatal tobacco use significantly increases the severity and duration of NAS, yet is not commonlytreated among opioid dependent pregnant women. Our team developed the Model for Cessationfor Women of Childbearing Age, an established framework that operationalizes perinatal smoking cessation success using a ‘real world’ approach. Primary motivators and lifestyle characteristics of perinatal women who do not relapse to tobacco were centered on women ‘takingaction’ while simultaneously replacing negative health behaviors with positive healthy behaviors, including physical activity and demanding a smoke-free, tobacco-free home environment. Phase 1 of this work developed and evaluated an online perinatal tobacco treatment certification program for providers including identification of facilitators and barriers of providing tobacco treatment alongside substance use disorder treatment. To complete contractgoals, we will partner with the Kentucky Opioid Response Effort (KORE) program to provide a comprehensive targeted response to Kentucky’s opioid crisis by expanding delivery of perinatal tobacco treatment as a concurrent treatment for opioid use disorders with our program KORE: Perinatal Action for Concurrent Tobacco Treatment (K-PACT). Phase 2 expands the provider and healthcare staff/professionals perinatal tobacco training by integrating feedback from K-PACT completers to modify K-PACT and ensure acceptability. The team disseminated K- PACT Perinatal Tobacco Training within select KORE sites, in consultation with the KORE Program Director. Phase 2 also included development and testing of an interactive platform for patient education for tobacco cessation. Brief, targeted, patient education messaging materials (< 5 minutes) will be delivered using multimedia platforms and patient testimonials. As with Phase 1, the pilot sites for the patient education series will be selected with KORE program director input. Phase 3 of this project will review the K-PACT provider training modules and incorporate any new scientific data to ensure all modules’ content represents the latest research data and evidence-based methods and findings related to perinatal tobacco use, smoking cessation counseling, and concurrent treatment for women with SUD who also smoke tobacco. Phase 3 will also further disseminate the K-PACT provider training across Kentucky through collaborations with Kentucky organizations, such as the Kentucky Tobacco Prevention and Cessation group (KTPC) and the Kentucky Perinatal Quality Collaborative, in consultation with the KORE Program Director. Lastly, Phase 3 of this project will integrate feedback from the Phase 2 evaluation of the patient tobacco cessation platform to ensure acceptability, and disseminate the patient education to applicable KORE sites, in conjunction with the KORE Program Director.