Baby & Me Tobacco Free

Overview

The Daviess County Health Department offers smoking cessation classes for pregnant women. These classes offer smoking cessation tools and accountability to participants to assist with tobacco cessation.

The goal of the program is to improve the health outcomes of these mothers as well as improve the health of infants. Diaper vouchers and other free incentives are given to women who are successful in this program.

How To Participate:

There are no income or age requirements to enroll. Women are eligible to enroll if they currently use tobacco products or have used tobacco products within three months of becoming pregnant.

This nationwide program follows the Clinical Best Practice Guidelines for Treating Tobacco Dependency and is very successful, with a 60% + quit rate among those enrolled.

To learn more or schedule an appointment, call (812) 254-8666 or email educator@daviess.org or complete the form below.

Baby & Me Tobacco Free Program

Is the pregnant woman 36 weeks or less gestation?*
1. Yes
2. No
Is the pregnant woman a current tobacco user, quit since becoming pregnant, or quit within 3 months of becoming pregnant? *
1. Yes
2. No
If either answer is 'No', she is not eligible to enroll in the BABY & ME- Tobacco Free Program. For more information, please contact us.
Andrea Brown- Public Health Educator
andrea.brown@daviess.org
300 E Hefron Street, Suite 150
Washington, Indiana 47501
812-254-8666
If either answer, is 'Yes', please proceed to enroll in the BABY & ME-Tobacco Free Program by completing the information below.
First Name
Last Name
Email Address
Address
City
State
Zip Code
Phone Number
Date of Birth*
Date of Birth
Estimated Due Date*
Estimated Due Date
I agree to be referred to the BABY & ME- Tobacco Free Program (BMTFP). I agree for the Facilitator of BMTFP to receive my personal information, to contact me, and to communicate my program status back to you as the Referring Organization.
If you do not have a referring agent, you can sign up as a self-referral.
Client Signature *
Referring Agency Name
Agency Contact First Name
Agency Contact Last Name
Agency Contact Phone Number
Agency Contact Email Address

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