“Breathe For Life”
at Healthy Start
Alise Gintner, LCSW
Manager of Community Perinatal Programs
Unity Health System &
The Perinatal Network of Monroe County
What is Breathe For Life?
A perinatal quit smoking and relapse
prevention program that focuses on
smoking cessation services combined
with relaxation techniques and stress
reduction interventions.
Smoking & Pregnancy
The U.S. Surgeon General
has reported that eliminating
smoking during pregnancy
could prevent 10 percent of
all infant deaths due to
perinatal conditions.
Theoretical Frameworks of
Breathe For Life
• Dr. Herbert Benson’s “Relaxation
Response”.
• The “5 A’s”.
• The Stages of Change
The Fight or Flight Response
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Anxiety and tension can trigger the
fight or flight response which releases
adrenaline, epinephrine and
norepinephrine into the body causing:
Increased heart rate
Increased breathing rate
Increased blood pressure
Increased metabolic rate
Stressful Life Events and
Physiological Changes
When we are faced with situations that
require adjustment of our behavior
(like quitting smoking) the fight or
flight response is triggered.
The “Relaxation Response”
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When the mind is focused, whether
through meditation or other repetitive
mental activities, the body responds with a
dramatic:
Decrease in heart rate
Decrease in breathing rate
Decrease in blood pressure
Decrease in metabolic rate
Coping with Stress
The fight or flight response can be
balanced with the relaxation response.
In other words: Mind-focusing
relaxation techniques can be used to
decrease the impact of stressful life
experiences.
Mind-Focusing Relaxation Techniques
Deep Breathing
Mind-Focusing Relaxation Techniques
Meditation
Mind-Focusing Relaxation Techniques
Progressive
Muscle
Relaxation
Mind-Focusing Relaxation Techniques
Guided
Imagery
Mind-Focusing Relaxation Techniques
Yoga
Mind-Focusing Relaxation Techniques
Sand Mandalas
The 5 A’s
• An evidence-based clinical approach to
helping pregnant women quit smoking.
• Consists of a 5 to 15 minute counseling
session.
• Includes providing the patient/client
with pregnancy specific quit-smoking
help materials.
The 5 A’s
ASK about smoking behavior
ADVISE about the risks of smoking
ASSESS her willingness to quit
ASSIST her with ways to quit by
teaching skills and providing support
• ARRANGE follow-up appointments to
provide ongoing support or a referral
for more intensive services if needed.
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The Stages of Change Model
Behavior change is rarely a discrete,
single event. Most individuals move
gradually from being uninterested in
change, to considering a change, to
deciding and preparing to make a
change.
The Stages of Change Model
• Precontemplation Stage
• Contemplation Stage
• Preparation Stage
• Action Stage
• Maintenance
Precontemplation Stage
The individual does not even consider
changing. Smokers who are “in denial”
may not see that the advice applies to
them personally or is helpful.
Contemplation Stage
The individual is ambivalent about
changing. Giving up an enjoyed behavior
causes them a sense of loss despite the
perceived gain. During this stage,
individuals assess barriers (time, expense,
hassle, fear, “I know I need to, but..”) as
well as the benefits of change.
Preparation Stage
The individual prepares to make a specific
change. They may experiment with
small changes as their determination to
change increases. Switching to a
different brand of cigarettes signals that
they have decided a change is needed.
Action Stage
The individual takes action to change
their behavior. Any positive action
should be praised as it demonstrates
the desire for lifestyle change.
Maintenance
Involves incorporating the new behavior
(the behavior change) over the long haul.
Many individuals find themselves
“recycling” through the stages of change
several times before the change becomes
truly established.
Relaxation & The Stages of
Change
The individual must
internalize relaxation
coping skill to improve
success rate with
quitting smoking.
2008 Breathe For Life Results
Sample size = 52
•63% quit smoking
•34% decrease number of cigarettes
smoked by more than half.
•3% no change.
Guided Imagery Exercise