Cost savings associated with smoking cessation for low-income pregnant women.

Despite the many health risks associated with smoking during pregnancy, it remains a chief public health concern with a high prevalence evident at the local level. In Wisconsin, the First Breath program was developed to help pregnant smokers quit and served 424 women during its pilot phase in 2001 and 2002. This cost savings analysis included claims associated with First Breath enrollees who were identified within the Wisconsin Medicaid data warehouse. This analysis allowed for a comparison of medical claims for women who quit smoking through the First Breath program versus those who continued to smoke. Three billing categories were included in this analysis: mother's maternity admissions (maternal DRG), inpatient neonatal care (neonate DRG), and infant's medical costs for the first 6 months of life. Average Medicaid savings per First Breath enrollee who quit smoking was 1274 dollars. Applying this savings to the actual number of women who quit smoking during the pilot study gives a total savings of 137,592 dollars for the Medicaid program. Considering the maximum Medicaid cost of providing cessation services to all First Breath participants, the return on investment associated with the First Breath program is 9 to 1.