Be Strong: Tobacco and Vaping Cessation

Smoking, Vaping, and Lung Cancer

Using tobacco is the main cause of cancer and cancer-related deaths that can be avoided. Smoking cigarettes is the number one cause of lung cancer, and it also raises the risk for other cancers like head and neck cancer, pancreas cancer and colorectal cancer. While Colorado’s smoking rates are a bit lower than the U.S. average, some rural areas, specific racial and ethnic groups, and people without insurance have higher rates. Vaping (e-cigarette use) rates among Colorado youth are increasing and are two times higher than the national average. Studies show that vaping can cause lung damage and is harmful to brain development in young people. Nicotine in tobacco and vaping products is highly addictive, which makes it hard to quit.

What is the project?

The Be Strong program seeks to provide education about the harmful effects of tobacco products on health and well-being and access to a FREE vaping/tobacco cessation program for Coloradans.

• Education. COE is available to give educational presentations about tobacco/vaping and health at schools, community meetings and events, and workshops.  We can also share educational materials for local or state-wide distribution.
  
• Tobacco Cessation Program. COE is collaborating with 2Morrow Inc. to offer access to their smoking and vaping cessation program, 2Morrow Health, which is available through a smartphone app. The program has modules for vaping, tobacco and for pregnant women who want to quit. It also offers access to professional coaches if desired.

What is the 2Morrow Health Mobile App?

2Morrow Health, Inc. is a private company and industry leader offering evidence-based, digital health platforms. The 2Morrow Health app teaches tobacco and e-cigarette users how to self-administer techniques to manage unhelpful thoughts, urges, and cravings caused by nicotine addiction. The app uses a behavioral model called “acceptance and commitment therapy” that helps participants learn how to cope with triggers that make it difficult to quit tobacco.

Who is it for?

The 2Morrow Health Mobile App is available to adults and adolescents (age 13 or older) who live in Colorado. This program is FREE for eligible individuals until July 2025.

How does it work?

The program is available via a smartphone app. You can access it by downloading the app to your smartphone or mobile device at 2morrowhealth.net/UCCC.  After downloading it, complete the sign-up process and create your own login and password to start using the app. The program offers custom content for adults who smoke, pregnant women, and young people who vape.

How much does it cost?

If you sign up and start the program, you can use it for up to 12 months after you sign up at no cost.

How do I sign up?

Visit https://2morrowhealth.net/UCCC. For more information, contact: Sindy Gonzalez, MPH, Sr. Community Outreach Coordinator, sindy.gonzalez@cuanschutz.edu

Baby and Me: Nicotine Cessation During Pregnancy

Nicotine Use During Pregnancy and Birth Outcomes

Smoking/vaping during pregnancy is the single most modifiable cause of infant morbidity and mortality in the US1. Nicotine use during pregnancy is associated with pre-term birth, NICU stays, and low weight deliveries.

Vaping during pregnancy is on the rise in Colorado2. The tobacco industry has marketed vaping as a safe alternative to smoking combustible tobacco or as a cessation tool. However, nothing could be further from the truth. Vaping can deliver huge doses of nicotine to users, with some devices containing more than 4x more nicotine than a pack of cigarettes. In addition, vaping results in inhaling toxic chemicals, heavy metals, and flavoring that is linked to lung disease. Vaping during pregnancy can lead to low birth weight, placenta issues, and pre-term birth.

Pregnancy is a crucial window of opportunity to break nicotine addiction. Many women who smoke before pregnancy are able to spontaneously quit before their first prenatal visit with their provider3. However, more than half of spontaneous quitters return to tobacco use by 3 months postpartum4. Nicotine is an extremely addictive chemical, and quitting represents one of the most challenging but reward experiences in one’s life.

The Baby & Me Tobacco Free Program

The Baby & Me Tobacco Free Program is a counseling program that helps pregnant people quit smoking and vaping. The program uses personalized counseling sessions, biomonitoring feedback, and financial incentives to help pregnant people quit and stay quit. The goal of Baby and Me is to help people achieve a lifetime quit from tobacco and nicotine products.

Who can participate?

People are eligible for the program if they are less than 37 weeks pregnant and if they:

- Smoked, vaped, or used nicotine pouches during their pregnancy

OR

- Smoked, vaped, or used nicotine pouches in the 3 months prior to getting pregnant

There are no other eligibility requirements.

What does the program include?

Participants can participate in 4 sessions during their pregnancy and 6 sessions after their baby is born. At each counseling session, participants perform a biomonitoring test to determine if they are tobacco free. Participants are eligible for up to $400 in gift cards if they attend all sessions!

In addition, if program participants live with someone that smokes or vapes and is ready to quit, that person is eligible for 6 counseling sessions after the baby is born as well. The supportive partner is eligible for up to $300 in gift cards if they attend all sessions.

How does it work?

Sessions can be delivered by telehealth or in-person. There are select public health agencies around Colorado that provide in-person Baby and Me services.

How do I sign up?

Participants can be referred by their providers or can refer themselves. To refer yourself, go to https://redcap.ucdenver.edu/surveys/?s=MLNT4LALWRX93JNJ and fill out the form.

A representative from Baby and Me will reach out to you within 3 business days.

Citations

Citations: 1. Dietz PM, England LJ, Shapiro-Mendoza CK, Tong VT, Farr SL, Callaghan WM. Infant morbidity and mortality attributable to prenatal smoking in the U.S. Am J Prev Med. 2010 Jul;39(1):45-52. doi: 10.1016/j.amepre.2010.03.009. PMID: 20547278.

2. Colorado Pregnancy Risk Assessment Monitoring Survey 2020-2022. https://cdphe.colorado.gov/center-for-health-and-environmental-data/survey-research/pregnancy-risk-assessment-monitoring 

3. Panjari M, Bell RJ, Astbury J, Bishop SM, Dalais F, Rice GE. Women who spontaneously quit smoking in early pregnancy. Aust N Z J Obstet Gynaecol. 1997 Aug;37(3):271-8. doi: 10.1111/j.1479-828x.1997.tb02407.x. PMID: 9325503.

4. Quinn, V. P., Mullen, P. D., & Ershoff, D. H. (1991). Women who stop smoking spontaneously prior to prenatal care and predictors of relapse before delivery. Addictive Behaviors, 16(1-2), 29–40. https://doi.org/10.1016/0306-4603(91)90037-I