The Smoke-Free Families Program

Tobacco remains the leading cause of preventable deaths in the United States. Since 1991 the Robert Wood Johnson Foundation has given high priority to reducing smoking, expending more than $142 million on a wide range of tobacco-control activities. The Foundation's efforts were singled out by Joel Fleishman in his book The Foundation: A Great American Secret, as one of 12 foundation-driven initiatives that have achieved high impact.

Previous volumes of the Anthology have featured 10 chapters on the Foundation's tobacco-control work. In this chapter, Fen Montaigne examines a single program, Smoke-Free Families, which was designed to find ways to help pregnant smokers quit. Set in the context of a clinical guideline issued by the U.S. Public Health Service recommending ways (called the 5 A's) that physicians can help their patients stop smoking, the Smoke-Free Families program funded research on counseling techniques and other ways to motivate pregnant women to stop smoking; demonstration programs to test apparently effective methods; and broad dissemination of methods that have been shown to be workable, so that they become a standard component of prenatal care.