In an effort to help Pittsburgh lose the dubious distinction of having the highest smoking rate among pregnant women in the country, a partnership of public and private agencies has launched a campaign to help moms-to-be put out their cigarettes.

		Tobacco Free Allegheny For more information about Tobacco Free Allegheny and the Target gift card incentive program, call 412-578-7910. Pennsylvania's Free Quitline can be reached at 1-877-724-1090. Related article Undaunted legislator still pushing for smoking ban

Among other strategies, Tobacco Free Allegheny, a nonprofit group created two years ago by the Allegheny County Board of Health, and some 30 community groups, hospitals, health plans and other agencies will try an incentive program that rewards pregnant smokers who quit with up to $75 in gift cards from Target.

In addition, Estelle Richman, secretary of the state's Department of Public Welfare, announced at yesterday's gathering at Magee-Womens Hospital several policy changes to make smoking cessation aids more accessible for people on medical assistance.

For the past 10 out of 11 years, Pittsburgh has held the worst spot among the 50 largest U.S. cities in an annual review of smoking rates among pregnant women.

According to 2002 state data, Pittsburgh's maternal smoking rate was 22.7 percent and Pennsylvania's was 15.8 percent. The national average was 12 percent.

"We need to get that down to less than 10 percent and we'd like to get there within two to three years," said Dr. Bruce Dixon, county health director and chairman of Tobacco Free Allegheny.

"Women who smoke are more likely to deliver babies that are up to 1 pound smaller than [babies of] nonsmokers or quitters," said Dr. Peg Watt-Morse, a Magee obstetrican. "They're twice as likely to deliver pre-term and their kids are three to four times more likely to die of SIDS."

Bob Nelkin, director of Smoke Free Mothers/Smoke Free Families Coalition, said doctors will get "tool kits" containing a list of cessation classes and contact numbers, like the Pennsylvania Free Quitline.

The initiative also includes a radio ad in which a woman talks about quitting smoking for the sake of her unborn son. At first, more media messages were planned.

"Instead, we had an 'Aha!' moment," Nelkin said. "We chose to put this money instead into the pockets of the pregnant women themselves."

In an incentive program, 225 pregnant women will get $50 Target gift cards upon completion of a smoking cessation program, which is free. If a breath test shows they still aren't smoking two months later, they get an additional $25 gift card.

The campaign will try to do more outreach in the African-American community, Nelkin said. According to the county Health Department, 23 percent of black women smoked during pregnancy, which is 48 percent higher than in other groups.

The experts also noted that women on Medicaid had double the pregnancy smoking rates of those who weren't.

Richman announced several medical assistance policy changes that could make it easier for smokers on medical assistance to quit.

Because experts say it takes an average of seven attempts to quit successfully, the amount of allowed cessation counseling sessions will go from 2.5 hours to 17.5 hours annually.

"I'm still not sure that's enough, but it's so much better," Richman noted.

Also, a policy that prohibited physicians from billing an office visit and a counseling session on the same day will be removed, encouraging prenatal visits to be followed with a discussion of smoking cessation.

Medicaid recipients eligible for a pharmacy benefit will get more prescription refills for approved smoking cessation drugs. Richman added that a primer would be developed to educate providers about Medicaid payment policies for tobacco cessation efforts.