Innovative Online Training on Adverse Effects of Electronic Cigarettes during Pregnancy

Background: Decreasing the prevalance of smoking among pregnant women is a public health priority in the United States, and there has been significant progress in recent years toward achieving this goal. However, the increased availability of electronic nicotine delivery systems (ENDS), often called e-cigarettes, may threaten the recent gains in reducing tobacco use among pregnant women. Current guidelines recommend counseling as the first line approach for tobacco cessation, and providers can use prenatal care visits as an opportunity to educate women about the risks of ENDS use during pregnancy. However, studies have found that healthcare providers report low levels of knowledge about ENDS, and there are few training materials on ENDS available for providers.

Program background: “Smoking Cessation for Pregnancy and Beyond: A Virtual Clinic,” is a online training originally released in 2011, and designed for healthcare professionals to assist pregnant women to quit smoking. In 2016, a CDC team led an effort in collaboration with external partners to develop and incorporate a new and innovative segment, “E-Cigarettes and Pregnancy,” into the training. In this interactive presentation, health professionals learn how ENDS work, what chemical components they contain, and review the scientific evidence regarding their health effects within the context of popular culture. The training includes current clinical recommendations and provides learners with interactive case studies, counseling demonstrations, and evidence-based lectures from renowned experts in the field.  

Evaluation Methods and Results: During the month of the launch of the new e-cigarette segment (August 2016), there was a 667% increase in participants compared with the month prior, from 66 to 506. In total, the training has been accessed by 2,743 learners, and 1,852 individuals have completed continuing education credit. At least 3 state tobacco and maternal and child health programs (Ohio, Indiana, and West Virginia) have used this training as part of tobacco control initiatives. If a provider counsels an average of 140 pregnant women per year (with 10% being smokers), we estimate our training has reached over 38,000 women; thereby delivering evidence-based intervention to reduce tobacco use during pregnancy.

Conclusions: This project expanded an existing online training for health professionals by adding a new educational segment on e-cigarettes. After the addition, the number of participants increased significantly.

Implications for research and/or practice: “Smoking Cessation for Pregnancy and Beyond: A Virtual Clinic” offers health professionals the opportunity to learn about ENDS and their potential adverse health effects during and after pregnancy, practice cessation counseling with a variety of patients, interact with renowned experts who act as mentors, attend up-to-date and evidence-based lectures, and earn continuing education. This training can be scheduled around a busy clinical practice, is available all the time, and doesn’t require travel. Innovative online trainings, such as this one, hold promise for reaching health professionals and helping them to assist pregnant women to quit smoking.