Program Report National action plan to reduce smoking during pregnancy: The National Partnership to Help Pregnant Smokers Quit C. Tracy Orleans, Cathy L. Melvin, Joseph F. Marx, Edward Maibach, Kathryn Kahler Vose [Received 11 April 2003; accepted 3 July 2003] Although there has been remarkable progress and momentum toward achieving smoke-free pregnancies in the United States since 1990, concerted action is needed to close the remaining gaps in treatment and prevention so that we can reach the Healthy People 2010 goal for pregnant smokers: a prevalence of 1% or less. This need for action led to the formation of the National Partnership to Help Pregnant Smokers Quit, a collaboration among more than 50 organizations and agencies, public and private, that have joined forces to help pregnant smokers quit by providing proven clinical and community-based interventions to every pregnant smoker. This article summarizes the action plan developed by the partnership, the strategies it outlines, and some of the actions taken by partners over the past year to put the plan into action. Action is planned and progress is being made in five strategic areas: offering help through the health care system; using the media effectively; harnessing community and worksite resources; promoting policies known to increase smoking cessation efforts and successes; and expanding national research, surveillance, and evaluation efforts. Introduction The 1990 Surgeon General’s Report on Smoking and Health (U.S. Department of Health and Human Services [USDHHS], 1990) provided compelling evi- dence for the harms of smoking and the benefits of quitting during pregnancy, and established smoking as the most important modifiable cause of poor preg- nancy outcome among women in the United States. Since 1990, enormous progress has been made in promoting and achieving smoke-free pregnancies and creating unprecedented policy and environmental supports for quitting: . The percentage of women who smoke during pregnancy has declined every year from 1989 to 2000, with current national estimates for smok- ing during pregnancy ranging from 12% to 20% (Martin, Hamilton, Ventura, Menacker, & Park, 2001). Tobacco use has fallen more rapidly among pregnant smokers than among the general popula- tion of women of childbearing age (USDHHS, 2001), and growing numbers of pregnant smokers are aware that smoking is harmful to their health and the health of their babies and are interested in quitting. . Sufficient research evidence has been amassed to support, for the first time, an evidence-based recom- mendation for brief pregnancy-tailored counseling for routine use in prenatal care (Figure 1; Fiore et al., 2000). According to the Treating Tobacco Use and Dependence clinical practice guideline (Fiore et al.), these brief, easy-to-implement prenatal coun- seling approaches have been found to double or ISSN 1462-2203 print/ISSN 1469-994X online # 2004 Society for Research on Nicotine and Tobacco DOI: 10.1080/14622200410001669105 C. Tracy Orleans, Ph.D., and Joseph F. Marx, B.A., The Robert Wood Johnson Foundation, Princeton, NJ; Cathy L. Melvin, Ph.D., M.P.H., University of North Carolina at Chapel Hill; and Edward Maibach, Ph.D., and Kathryn Kahler Vose, M.A., Porter Novelli, Inc, Washington, D.C. Correspondence: C. Tracy Orleans, Ph.D., Senior Scientist, The Robert Wood Johnson Foundation, Post Office Box 2316, College Road East and Route 1, Princeton, NJ 08543 USA. Tel.: z1 (609) 627-5962; Fax: z1 (609) 627-6415; E-mail: cto@rwjf.org Nicotine & Tobacco Research Volume 6, Supplement 2 (April 2004) S269–S277