The University Record, April 16, 2001

Smoking-cessation counseling can help prevent SIDS deaths

By Colleen Newvine
News and Information Services

Providing basic smoking-cessation counseling to pregnant women could prevent 108 cases of sudden infant death syndrome (SIDS) each year, according to a study published recently in the American Journal of Public Health. The counseling services also are highly cost-effective, according to the study.

“For every million dollars spent on basic smoking-cessation counseling to pregnant women, we can save almost five infants from dying as a result of SIDS. That is $210,000 per life saved from SIDS. The accepted threshold for cost effectiveness of a health measure is more than $7 million per life saved,” says study author Harold Pollack, assistant professor of health management and policy at the School of Public Health.

“Of the 3,000 SIDS deaths each year, more than 700 are related to maternal smoking. All 700 deaths appear to be preventable if expectant mothers quit smoking. This study shows that it is possible to prevent up to 108 of those deaths with basic smoking-cessation counseling. These smoking-cessation services are highly cost-effective when compared with child auto safety seats and other interventions Americans value to save and extend human life,” Pollack says. “The cost of basic smoking-cessation counseling services used in this study were estimated at about $45 per participant, based on previous research.”

Pollack used birth certificate data for more than 2.9 million infants from the federal government’s 1995 and 1996 Perinatal Mortality Files to examine SIDS incidence among U.S. infants born in 1995. All U.S. infants were included for whom maternal smoking during pregnancy was recorded. The analysis controlled for other variables, such as maternal education, age and marital status at delivery, and infant birth weight, to identify the impact of smoking on SIDS risks. The study confirmed prior research that smoking by pregnant women more than doubles the risk of SIDS death. SIDS incidence was highest among infants born to heavy smokers.

Consistent with previous studies, African American infants had a higher SIDS risk, while Hispanic/Latino infants experienced lower rates than either African Americans or non-Hispanic whites.

“Although smoking is a difficult behavior to change, smoking cessation can have a large impact on infant and maternal health. Expectant mothers are highly motivated to quit smoking, but they need information and encouragement from their health care providers,” Pollack says.

When an infant dies unexpectedly of no apparent cause, the SIDS diagnosis often is made. Although the precise etiology of SIDS is unknown, it remains the leading cause of U.S. infant deaths after the first month of life, accounting for more than 2,500 deaths annually.

The Substance Abuse Policy Research Program of the Robert Wood Johnson Foundation funded Pollack’s research.

For more information about SIDS, visit the Web at