Dartmouth Medical School will use a $230,000 grant it received last week to test a novel approach to helping pregnant women quit smoking.
Dr. Judith Frank and Dr. Douglas Hoffman will direct the two-year project which will test the levels of the nicotine metabolite, cotinine in pregnant women.
"The cotinine level is the measure of your smoking," Hoffman said. "We can't make anybody quit smoking. Telling them how much nicotine metabolite they have in their system will be a motivational and educational tool."
Working in conjunction with New Hampshire Maternal and Child Health prenatal clinics, doctors at DMS will test the clinics' clients by "simply taking some of their throwaway urine and measuring it for cotinine," Hoffman said.
The participants will be educated on the direct relationship between smoking and cotinine levels through graphs, cartoons and other means, according to a press release put out by the Medical School.
"There is some indication that this kind of feedback will work," Hoffman said. "Nothing as direct an intervention as this has been done before."
"Our society has to confront its ambivalence about toxic and addictive substances which have remained legal," Hoffman said. "These guys at the tobacco companies are there to make money, and they do it by killing people."
"Cigarette smoking is the single most identified cause of adverse birth outcomes," he said.
Cigarette advertisements targeting young women and children adversely affect his work, Hoffman explained.
Planned Parenthood of Claremont will be one of the clinics participating in the project, Site Manager Carolynn Ernst said.
"A representative of the project is coming to talk to us on the March 12," Ernst said. "The staff here at Planned Parenthood is really excited about the possibilities the grant offers to clients in their attempt to quit smoking."
The clinics will maintain their counseling role throughout the project because the combination of testing and counseling increases the participant's chances of quitting smoking, Hoffman said.
Dartmouth Medical School will perform the biochemical analyses for all of the participants nationwide, he added. Ten sites will participate in the project.
"The biochemical verification of each subject's smoking status will be processed here," Hoffman said. "We've had a lot of experience in this laboratory in providing drug abuse testing in support of substance abuse counseling."
"Other groups are testing different interventions," he said. "We are all sharing common evaluative measures and will be pooling them together" at the end of the two year period.
After the project, Hoffman and Frank hope to publish their results.
"We're hoping that we will be able to apply the results to a more general population," Hoffman said.
Frank was unavailable for comment, but Hoffman cited her continuous work with smoking related birth defects.
"She sees a lot of babies with significant health problems that are connected with their mother's smoking," he said.
"We're hoping that it [the project] works," Hoffman said. "Substance abuse testing helps to keep people from using the addictive substance."
Ultimately, "we are trying to empower them [pregnant women] to stop smoking, but it's really up to them," he added.
"The overall program goal is to increase the number of women who stop smoking and remain smoke-free," according to the press release.
The 10 sites meet regularly to discuss the project. The next meeting will be in Chicago this April, Hoffman said.
The location of the sites vary from San Diego, Calif., and Portland, Ore., to the nearby laboratory of Dr. Laura Soloman at the University of Vermont.
Dr. Judith Frank is an associate professor of pediatrics at DMS and chief of the Dartmouth-Hitchcock Medical Center's neonatology division, according to the press release.
Hoffman is an associate professor of psychiatry, pharmacology and toxicology at DMS as well as the director of the neurochemistry laboratory there.
The Robert Wood Johnson Foundation awarded 10 grants nationwide totaling $2.4 million to support the program, "Smoke Free Families: Innovations to Stop Smoking During and Beyond Pregnancy."
The Foundation is the largest national philanthropic organization devoted exclusively to health and health care, Communications Assistant Ann Searight said.
Searight said "reducing harm caused by substance abuse," is one of the foundation's four areas of concern.
"Smoking is certainly an area we are interested in," she said. "We just announced that we will be funding the campaign for tobacco-free kids on Monday."
The foundation will devote $20 million towards this campaign.
