“…In the general pregnant population, 20-45% of women spontaneously quit smoking upon becoming pregnant (Quinn, Mullen, & Ershoff, 1991; Solomon & Quinn, 2004; Woodby, Windsor, Snyder, Kohler, & Diclemente, 1999), while almost no pregnant women in medication-assisted treatment for an opioid use disorder quit spontaneously (Chisolm et al, 2013; Jones et al, 2009). The American College of Obstetricians and Gynecologists (ACOG) and the U.S. Department of Health and Human Services recommend that obstetrical providers ask all pregnant women about tobacco use and provide pregnancy-tailored counseling based on the “5 A's” counseling model (Albrecht, Phelan, & Melvin, 2011; Fiore et al, 2008).…”