UB professor looks to help pregnant women quit smoking through research

Study to assist low socioeconomic status, expectant women

smoking-research

Rebecca Kennedy spent two years recovering from her drug addiction.

Kennedy, who started smoking cigarettes at 12 years old, is now a 24-year-old mother.

As her five-month-old son Jaxson plays on her lap, Kennedy said she feels like she’s been judged her whole life.

“But I was never judged here for smoking while I was pregnant. Here, it was really the encouragement that helped me quit smoking,” Kennedy said.

Kennedy now lives a cigarette-free lifestyle and is part of a research study, which aims to help pregnant women stop smoking. The study is part of research by Dr. Xiaozhong Wen, an assistant professor in the department of Pediatrics at the Jacobs School of Medicine and Biomedical Sciences.

Wen’s ongoing study, which started in 2015, includes three phases. 

During the first phase, the mother is provided educational pamphlets that contain information about how smoking cigarettes affects their child. 

While they read the pamphlets, expectant mothers also undergo counseling sessions twice a week for two weeks and once a week for six weeks. Kennedy said the reading materials helped her decide to stop smoking altogether. 

The second phase of the study requires expectant mothers to keep a calendar of how many cigarettes they smoke each day. 

The mothers then have to undergo two tests, which track carbon monoxide and urine cotinine levels. Wen said the results of the test provide further encouragement for expectant mothers to stop smoking. 

“A lot of mothers look forward to the changes in their carbon monoxide test levels,” Wen said. “With smoking, you don’t need to stop completely to see a positive change.”

The carbon monoxide reflects recent smoking activity, according to Wen, so when expectant mothers reduce the number of cigarettes they smoke, they can see changes in carbon monoxide levels within a few days. 

This type of feedback, according to Wen, is essential to help expectant mothers quit smoking. 

“Like any behavioral change, smoking cessation requires feedback. So we make sure to provide that feedback and encouragement and support,” Wen said.

The third phase of the study rewards expectant mothers who test negatively for carbon monoxide and cotinine, with financial incentives. These incentives are given in increments depending on the duration of the absence of carbon monoxide and cotinine. 

Currently, expectant mothers receive $10 on the first visit that they test negatively for carbon monoxide and cotinine, according to Wen. The amount increases to $15 on the next consecutive visit with negative levels, and the mother receives $25, which is the highest compensation.  

When asked what part of the study helped her quit smoking the most, participant Natasha Frazier said it was about getting paid.

Wen said many of his patients really enjoyed the compensational aspect of the study.

“Especially because many of them have low socioeconomic status. This might not be big money for middle or high income patients, but for these patients, this money can make a big difference,” Wen said.

Wen’s study includes Buffalo community members from underprivileged and low socioeconomic status backgrounds, a fact which has made the study a top priority to UB’s Clinical and Translational Science Institute.

“We just want to help everyone regardless of their financial status … but the fact is that 84 percent of persistent smokers during pregnancy are low [socioeconomic status],” Wen said.

“They have a high propensity for smoking before pregnancy and low propensity to quit during and after their pregnancy.”

Low socioeconomic status women are more likely to smoke, according to Wen, due to higher stress based on dire or ambiguous financial situations, relationship issues and their environment.

“I visit them during home visits. If I had to live in that environment where relationships with family members are tense, or the financial situation is like that, I guess I would have a lot of stress too,” Wen said.

Clara Bradizza, senior research scientist at UB’s Research Institute on Addictions found in her research that pregnant women were more likely to quit smoking once they learned to manage negative emotions.  

Low socioeconomic status women, however, have fewer alternatives for stress relief and managing negative emotions, according to Wen.

“If you’re middle or high income, you may have other alternatives to reward yourself. … You can go shopping, you can watch movies or travel. You can do a lot of healthy, happy things,” Wen said. “But for most of our patients, you don’t have the resources or enough money or time. But they do have cigarettes.”

Wen’s study, however, allows low socioeconomic status women the opportunity to stop smoking through education, counseling and monetary incentives that would also improve their household finances. 

Kennedy and Frazier said they stopped smoking altogether and have no plans to ever start again.

“I was worried I wouldn’t take to it. But, thinking about it, it’s only helping me live longer. It’s only helping my baby live longer. There’s only positive outcomes that come from this,” Frazier said.

Tanveen Vohra is a staff writer and can be reached at features@ubspectrum.com.