Medi-Cal Incentives to Quit Smoking Program: Reach to Pregnant and Parenting Women

Am J Prev Med. 2018 Dec;55(6 Suppl 2):S205-S213. doi: 10.1016/j.amepre.2018.07.016.

Abstract

Introduction: In California, half of pregnant women and children are on California's Medicaid (Medi-Cal). The Medi-Cal Incentives to Quit Smoking program provided incentives to adults on Medi-Cal to call the California Smokers Helpline (Helpline) from March 2012 to July 2015. This analysis examined reach of the Medi-Cal Incentives to Quit Smoking program among pregnant and parenting women.

Methods: This study examined caller data from the Helpline from 2010 to 2015 among women of reproductive age (18-45 years) enrolled in Medi-Cal (n=32,691; analyzed in 2017/2018). The authors calculated the annual percentage of the target population reached who called the Helpline by pregnancy status and used adjusted prevalence ratios to examine the associations between Medi-Cal Incentives to Quit Smoking incentive period, pregnancy/parenting status, Medi-Cal Incentives to Quit Smoking incentives ($20 gift card and nicotine patch), and counseling.

Results: Over the study period, the percentage of the target population reached increased for women of reproductive age (2.1% in 2011 to 3.0% in 2014) and pregnant women (2.1% in 2011 to 3.3% in 2014). The percentage of women who asked for the $20 gift card (13.6%) was not substantially different by pregnancy status, and WIC and nonprofits were important referral sources. Pregnant women were less likely to receive nicotine patches, but there was a 3- to 4-fold increase during the Medi-Cal Incentives to Quit Smoking incentive period for both pregnant and nonpregnant women. Among nonpregnant women, counseling decreased 14% during the Medi-Cal Incentives to Quit Smoking incentive period.

Conclusions: Results suggest that the nicotine patch incentives motivated women to call the Helpline, even pregnant women who needed a physician's approval consistent with current American College of Obstetricians and Gynecologists cautions about the appropriateness of the patch during pregnancy.

Supplement information: This article is part of a supplement entitled Advancing Smoking Cessation in California's Medicaid Population, which is sponsored by the California Department of Public Health.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • California
  • Community-Institutional Relations
  • Counseling / statistics & numerical data
  • Direct-to-Consumer Advertising / methods*
  • Female
  • Health Promotion / methods*
  • Hotlines / statistics & numerical data
  • Humans
  • Marketing of Health Services / methods*
  • Medicaid / economics
  • Medicaid / statistics & numerical data*
  • Middle Aged
  • Parents / psychology
  • Patient Participation / psychology
  • Patient Participation / statistics & numerical data
  • Pregnancy
  • Program Evaluation
  • Reimbursement, Incentive / economics
  • Smokers / psychology
  • Smokers / statistics & numerical data
  • Smoking Cessation / economics
  • Smoking Cessation / methods*
  • Smoking Cessation / statistics & numerical data
  • Tobacco Use Cessation Devices / economics
  • United States
  • Young Adult