Perinatal Tobacco Treatment (K-PACT)

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 commonly treated among opioid dependent pregnant women. Our team developed the Model for Cessation for 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 ‘taking action’ while simultaneously replacing negative health behaviors with positive healthy behaviors, including physical activity and demanding a smoke-free, tobacco-free home environment. The next logical extension of this work is to develop and evaluate 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 contract goals, 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). Our expert team, including two nationally certified perinatal tobacco treatment specialist, is equipped to provide perinatal tobacco treatment educational trainings to providers on the following topics: Basics of Perinatal Tobacco Treatment: Breaking Through to Cessation; Tobacco Treatment with Special Populations, including perinatal women and women of childbearing age with substance use disorder; Electronic Cigarettes and the Perinatal Women, Families and their Children and; GET FIT and QUIT: A program integrating physical activity to replace perinatal smoking behaviors