The purpose of Get Fit and Quit (GFAQ) was to test the feasibility, acceptability, and efficacy of a comprehensive tobacco cessation program, including social support and group exercise, for women of childbearing age with substance use disorders (SUD). Kentucky leads the nation in perinatal tobacco and opioid use, and to the best of our knowledge, there are no current perinatal tobacco treatment programs for women with SUD that have reported participant cessation.
Methods
GFAQ is a 6-month program, including 10 sessions that were held at a community YMCA. Each session included physical activity and evidence based tobacco treatment. Intervention outcomes were measured at baseline, five weeks, three months, and six months via participant survey and biochemical validation of tobacco use. Preset urine cotinine limits validated smoking status; while CO levels were also measured. The Fagerstrom Test for Nicotine Dependence is a 6-item tool to measure individual level of dependence. Qualitative interview were conducted to determine acceptability of GFAQ.
Results
This study consisted of a 23 women of childbearing age (pregnant: 5; nonpregnant: 18). Nearly all (21 of 23) participants were White, Single and had a household income of less than $20,000. Sixteen participants were enrolled at the baseline session of GFAQ. Among the eleven participants who finished the study, nicotine dependence is significantly lower (p=0.004) at GFAQ session five compared to scores at enrollment, based on the Fagerstrom scores. There were no significant changes in CO levels; however, levels were lower at study conclusion. Three women have successfully quit smoking using the GFAQ program.
Conclusions and Implications for Practice
The results from this program support GFAQ as a feasible program with promising results impacting level of dependence. The finding that women with SUD were successful in attaining smoking cessation through the GFAQ program highlights the efficacy of this novel program. The clinical implications are that reduced levels of CO reduce the risk for adverse pregnancy outcome and decreased levels of dependence increase the likelihood of quitting.