scholarly journals Smoking During Pregnancy and Smoking Cessation Services

2009 ◽  
Vol 4 (S1) ◽  
pp. 2-5 ◽  
Author(s):  
Linda Bauld
Keyword(s):  
Smoking Cessation ◽  
Smoking During Pregnancy ◽  
Smoking In Pregnancy ◽  
Pregnant Smokers ◽  
Specialist Services ◽  
Quit Attempts ◽  
Stop Smoking Services ◽  
Poster Presentations ◽  
New Evidence ◽  
Improve Access

AbstractThe 2008 UK National Smoking Cessation Conference (UKNSSC) included a number of oral and poster presentations on the theme of smoking during pregnancy. This is a challenging area of research and practice and one in which new evidence — both about the effects of smoking in pregnancy and about smoking cessation interventions — is regularly emerging. Papers at UKNSCC explored why few women access support to stop (Felix Naughton), how best to refer women to specialist services (Joan Braithwaite), social marketing approaches (Deborah Richardson and Wendy Dudley) and physical activity for smoking cessation during pregnancy (Michael Ussher). The conference opened with a plenary presentation that explored the extent of smoking during pregnancy and women's accounts of quit attempts, cessation and relapse. It also examined what more could be done to improve access to stop smoking services for pregnant women and increase the proportion of women who quit. This article reviews some of the evidence presented at UKNSSC, focusing in particular on the need for improved identification, referral, engagement and treatment of pregnant smokers.

Emotion Regulation Difficulties and Social Control Correlates of Smoking among Pregnant Women Trying to Quit

2018 ◽  
Author(s):  
Jennifer Fillo ◽  
Kimberly E. Kamper-DeMarco ◽  
Whitney C. Brown ◽  
Paul R. Stasiewicz ◽  
Clara M. Bradizza
Keyword(s):  
Smoking Cessation ◽  
Emotion Regulation ◽  
Negative Affect ◽  
Social Control ◽  
Pregnant Women ◽  
Nicotine Dependence ◽  
Low Income ◽  
Withdrawal Symptoms ◽  
Smoking During Pregnancy ◽  
Pregnant Smokers

Approximately 15% of US women currently smoke during pregnancy. An important step toward providing effective smoking cessation interventions during pregnancy is to identify individuals who are more likely to encounter difficulty quitting. Pregnant smokers frequently report smoking in response to intrapersonal factors (e.g., negative emotions), but successful cessation attempts can also be influenced by interpersonal factors (i.e., influence from close others). This study examined the association between emotion regulation difficulties, positive and negative social control (e.g., encouragement, criticism), and smoking cessation-related variables (i.e., smoking quantity, withdrawal symptoms) among pregnant smokers. Data were drawn from the pretreatment wave of a smoking cessation trial enrolling low-income pregnant women who self-reported smoking in response to negative affect (N = 73). Greater emotion regulation difficulties were related to greater smoking urges (b = 0.295, p = .042) and withdrawal symptoms (b = 0.085, p = .003). Additionally, more negative social control from close others was related to fewer smoking days (b = -0.614, p = .042) and higher smoking abstinence self-efficacy (b = 0.017, p = .002). More positive social control from close others interacted with negative affect smoking (b = -0.052, p = .043); the association between negative affect smoking and nicotine dependence (b = 0.812, p < .001) only occurred at low levels of positive social control. Findings suggest that emotion regulation difficulties may contribute to smoking during pregnancy by exacerbating women's negative experiences related to smoking cessation attempts. Negative social control was related to lower smoking frequency and greater confidence in quitting smoking, suggesting that it may assist pregnant smokers' cessation efforts. Positive social control buffered women from the effects of negative affect smoking on nicotine dependence.

scholarly journals Experts’ Views on Behaviour Change Techniques for Smoking Cessation in Pregnancy: A Qualitative Study

2020 ◽  
Vol 17 (21) ◽  
pp. 7729
Author(s):  
Fizzah B. Abidi ◽  
Libby Laing ◽  
Sue Cooper ◽  
Tim Coleman ◽  
Katarzyna A. Campbell
Keyword(s):  
Smoking Cessation ◽  
Behaviour Change ◽  
Group Discussion ◽  
Behaviour Change Techniques ◽  
Visual Aids ◽  
Smoking During Pregnancy ◽  
Behavioural Support ◽  
Quit Attempts ◽  
The Family ◽  
In Pregnancy

Smoking during pregnancy is a global health problem which has devastating health implications. Behavioural support is an important part of smoking cessation support for pregnant women. Research has identified barriers and facilitators (B&Fs) and effective behaviour change techniques (BCTs) to aid women’s quit attempts. However, the extent to which and how these BCTs are used in practice is unclear. The research aimed to establish experts’ views on how behavioural support can be optimised and techniques operationalised in clinical practice, by identifying ways to address known B&Fs for smoking cessation in pregnancy. A focus group discussion took place with six experts, which highlighted how BCTs can be used in practice to support women in their quit attempts. A thematic analysis was conducted to elicit overarching themes. Five themes were found: involving the family, empowering women, using incentives to boost motivation, using practical techniques to help women with their quit attempts and managing expectations about nicotine replacement therapy. Empowering women to make their own decisions and encouraging small positive changes in smoking habits, using visual aids (e.g., growth charts) to inform women of the harms of smoking to the baby and treating families holistically were deemed important.

scholarly journals Interest in and Use of Smoking Cessation Support Across Pregnancy and Postpartum

2019 ◽  
Vol 22 (7) ◽  
pp. 1178-1186 ◽  
Author(s):  
Felix Naughton ◽  
Luis Reeves Vaz ◽  
Tim Coleman ◽  
Sophie Orton ◽  
Katharine Bowker ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Health Professional ◽  
Late Pregnancy ◽  
Cross Sectional ◽  
Quit Attempt ◽  
Pregnant Smokers ◽  
Pregnancy And Postpartum ◽  
Health Practitioners ◽  
Stop Smoking Services ◽  
And Behavior

Abstract Background Limited research exists on interest in and use of smoking cessation support in pregnancy and postpartum. Methods A longitudinal cohort of pregnant smokers and recent ex-smokers were recruited in Nottinghamshire, United Kingdom (N = 850). Data were collected at 8–26 weeks gestation, 34–36 weeks gestation, and 3 months postpartum and used as three cross-sectional surveys. Interest and use of cessation support and belief and behavior measures were collected at all waves. Key data were adjusted for nonresponse and analyzed descriptively, and multiple regression was used to identify associations. Results In early and late pregnancy, 44% (95% CI 40% to 48%) and 43% (95% CI 37% to 49%) of smokers, respectively, were interested in cessation support with 33% (95% CI 27% to 39%) interested postpartum. In early pregnancy, 43% of smokers reported discussing cessation with a midwife and, in late pregnancy, 27% did so. Over one-third (38%) did not report discussing quitting with a health professional during pregnancy. Twenty-seven percent of smokers reported using any National Health Service (NHS) cessation support and 12% accessed NHS Stop Smoking Services during pregnancy. Lower quitting confidence (self-efficacy), higher confidence in stopping with support, higher quitting motivation, and higher age were associated with higher interest in support (ps ≤ .001). A recent quit attempt and greater interest in support was associated with speaking to a health professional about quitting and use of NHS cessation support (ps ≤ .001). Conclusions When asked in early or late pregnancy, about half of pregnant smokers were interested in cessation support, though most did not engage. Cessation support should be offered throughout pregnancy and after delivery. Implications There is relatively high interest in cessation support in early and late pregnancy and postpartum among smokers; however, a much smaller proportion of pregnant or postpartum women access any cessation support, highlighting a gap between interest and engagement. Reflecting women’s interest, offers of cessation support should be provided throughout pregnancy and after delivery. Increasing motivation to quit and confidence in quitting with assistance may enhance interest in support, and promoting the discussion of stopping smoking between women and health practitioners may contribute to higher support engagement rates.

Isolation, Marginalisation and Disempowerment – Understanding How Interactions with Health Providers Can Influence Smoking Cessation in Pregnancy

2021 ◽  
Author(s):  
Cherise Fletcher ◽  
Elizabeth Hoon ◽  
Angela Gialamas ◽  
Gustaaf Dekker ◽  
John Lynch ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Focus Groups ◽  
South Australia ◽  
Antenatal Clinic ◽  
Health Providers ◽  
Smoking During Pregnancy ◽  
Healthcare Barriers ◽  
Adverse Health Outcomes ◽  
Smoking In Pregnancy ◽  
In Pregnancy

Abstract BackgroundMaternal smoking during pregnancy can lead to serious adverse health outcomes for both women and their infants. While smoking in pregnancy has declined over time, it remains consistently higher in women with lower socioeconomic circumstances. Furthermore, fewer women in this group will successfully quit during pregnancy. AimThis study explores the barriers to smoking cessation experienced by socially disadvantaged pregnant women and investigates how interactions with health providers can influence their smoking cessation journey.Methodsomen (either pregnant or birthed in the previous 10 years, who smoked or quit smoking in pregnancy) were recruited from a metropolitan public hospital antenatal clinic in South Australia and community organisations in surrounding suburbs. Seventeen women participated in qualitative semi-structured small focus groups or interviews. The focus groups and interviews were recorded, transcribed and thematically analysed. FindingsFour interconnected themes were identified: 1) smoking embedded in women’s challenging lives and pregnancies, 2) cyclic isolation and marginalisation, 3) feeling disempowered, and 4) autonomy and self-determination. Themes 3 and 4 are characterised as being two sides of a single coin in that they coexist simultaneously and are inseparable. A key finding is a strong unanimous desire for smoking cessation in pregnancy but women felt they did not have the necessary support from health providers or confidence and self-efficacy to be successful.ConclusionWomen would like improvements to antenatal care that increase health practitioners’ understanding of the social and contextual healthcare barriers faced by women who smoke in pregnancy. They seek assistance from health providers to make informed choices about smoking cessation and would like women-centred care. Women feel that with greater support, consistency and encouragement from health providers they could be more successful at antenatal smoking cessation.

scholarly journals Incentives for smoking cessation in pregnancy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Tappin ◽  
L Bauld
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Workers ◽  
Financial Incentives ◽  
Financial Incentive ◽  
Late Pregnancy ◽  
Incentive Payment ◽  
Smoking During Pregnancy ◽  
Pregnant Smokers ◽  
Care Workers

Abstract Issue/problem Most pregnant smokers reply ‘Yes' when asked ‘Do you want to stop smoking?'. This is usually an honest answer but often without intention. About 10% who intend to quit are likely to attend smoking cessation services. Even with good quality counselling and the offer of nicotine replacement therapy only about 3-5% quit. How can the other 90% be reached? There are two approaches: Redirect counselling away from specialist cessation practitioners and build capacity among all health care workers. This is attractive spreading counselling to health care workers who meet pregnant smokers during routine consultations requiring little resource after training for example General Practitioners, Midwives and Obstetricians. However limited time for training and subsequent counselling endangers the quality and quantity of counselling delivered.Increase the proportion of women who intend to quit smoking during pregnancy by providing a financial incentive payment for engaging with specialist cessation practitioners and quitting. This policy allows counselling to be delivered by specialists and potentially draws in a larger proportion of pregnant smokers, as many as 50%. Results Financial incentives have increased the proportion of smokers who quit by late pregnancy in two large randomised controlled trials. The proportion increased by more than 100%. Local service pilots of financial incentives have seen marked increases in smokers who attend and quit. Lessons There are a number of ways to increase smoking cessation among pregnant women. Research evidence should be translated into effective service models to decide which strategy is most cost-effective. Key messages Counselling is important; however, it has to be sufficient and of good quality. Drawing more pregnant smokers into cessation services will increase the proportion who intend and manage to quit. This may work better than expecting all health care workers to give effective counselling.

scholarly journals Practitioners’ Views on Nicotine Replacement Therapy in Pregnancy during Lapse and for Harm Reduction: A Qualitative Study

2019 ◽  
Vol 16 (23) ◽  
pp. 4791
Author(s):  
Ross Thomson ◽  
Lisa McDaid ◽  
Joanne Emery ◽  
Lucy Phillips ◽  
Felix Naughton ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Harm Reduction ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Policy And Practice ◽  
Nicotine Replacement ◽  
Social Ecological ◽  
Pregnant Smokers ◽  
Stop Smoking Services ◽  
The Uk

Many countries, including the UK, recommend nicotine replacement therapy (NRT) for smoking cessation during pregnancy. However, adherence to NRT is generally low, smoking lapse or relapse is common and using NRT to reduce the harm from the number of cigarettes smoked is only advocated in non-pregnant smokers. Two focus groups were conducted with 13 professionals involved in antenatal stop smoking services (SSS). The data were analysed thematically. Two themes were extracted that describe health professionals’ attitudes towards using NRT either during lapses or to reduce smoking in women who cannot quit (harm reduction). These are presented around a social–ecological framework describing three hierarchical levels of influence within smoking cessation support: (1) Organizational: providing NRT during lapses could be expensive for SSS though harm reduction could result in services helping a wider range of clients. (2) Interpersonal: participants felt using NRT for harm reduction was not compatible with cessation-orientated messages practitioners conveyed to clients. (3) Individual: practitioners’ advice regarding using NRT during smoking lapses varied; many were generally uncomfortable about concurrent smoking and NRT use and had strong reservations about recommending NRT when smoking during all but the briefest lapses. Further evidence is required to guide policy and practice.

scholarly journals Evaluation of a complex healthcare intervention to increase smoking cessation in pregnant women: interrupted time series analysis with economic evaluation

2017 ◽  
Vol 27 (1) ◽  
pp. 90-98 ◽  
Author(s):  
Ruth Bell ◽  
Svetlana V Glinianaia ◽  
Zelda van der Waal ◽  
Andrew Close ◽  
Eoin Moloney ◽  
...  
Keyword(s):  
Time Series ◽  
Carbon Monoxide ◽  
Smoking Cessation ◽  
Interrupted Time Series ◽  
Healthcare Intervention ◽  
Interrupted Time Series Analysis ◽  
Smoking During Pregnancy ◽  
Pregnant Smokers ◽  
Smoking Cessation Services ◽  
Quitting Smoking

ObjectivesTo evaluate the effectiveness of a complex intervention to improve referral and treatment of pregnant smokers in routine practice, and to assess the incremental costs to the National Health Service (NHS) per additional woman quitting smoking.DesignInterrupted time series analysis of routine data before and after introducing the intervention, within-study economic evaluation.SettingEight acute NHS hospital trusts and 12 local authority areas in North East England.Participants37 726 records of singleton delivery including 10 594 to mothers classified as smoking during pregnancy.InterventionsA package of measures implemented in trusts and smoking cessation services, aimed at increasing the proportion of pregnant smokers quitting during pregnancy, comprising skills training for healthcare and smoking cessation staff; universal carbon monoxide monitoring with routine opt-out referral for smoking cessation support; provision of carbon monoxide monitors and supporting materials; and an explicit referral pathway and follow-up protocol.Main outcome measuresReferrals to smoking cessation services; probability of quitting smoking during pregnancy; additional costs to health services; incremental cost per additional woman quitting.ResultsAfter introduction of the intervention, the referral rate increased more than twofold (incidence rate ratio=2.47, 95% CI 2.16 to 2.81) and the probability of quitting by delivery increased (adjusted OR=1.81, 95% CI 1.54 to 2.12). The additional cost per delivery was £31 and the incremental cost per additional quit was £952; 31 pregnant women needed to be treated for each additional quitter.ConclusionsThe implementation of a system-wide complex healthcare intervention was associated with significant increase in rates of quitting by delivery.

The Poole approach to a smoke-free pregnancy

2020 ◽  
Vol 28 (6) ◽  
pp. 346-350
Author(s):  
Heidi Croucher ◽  
Jillian Ireland
Keyword(s):  
Smoking Cessation ◽  
Public Health Issue ◽  
Service Improvement ◽  
Team Approach ◽  
Protected Time ◽  
Smoking In Pregnancy ◽  
Pregnant Smokers ◽  
Quitting Smoking ◽  
Main Driver ◽  
New Ideas

Smoking tobacco is both a pharmacological addiction and a serious social and public health issue. Smoking cessation services for pregnant women save babies' lives and have the potential to improve the health of families and communities. Engaging with pregnant smokers and their households towards quitting smoking requires a whole-team approach. Protected time for the specialist smoking in pregnancy team and freedom to develop the service improvement approach has been key in the setting described in this paper. The approach to smoking cessation described in this paper is of the quality improvement arm within the ‘Saving babies' lives’ bundle of interventions in Poole Hospital NHS Foundation Trust. The ‘plan, study, do, act’ model is described with a description of its implementation using sequential learning, enquiry, testing and being open to new ideas and approaches. The main driver questions have been: ‘how do we reach pregnant smokers who are not motivated to quit?’ and ‘what approaches will potentiate success for this group?’

scholarly journals Building an Indigenous-Led Evidence Base for Smoking Cessation Care among Aboriginal and Torres Strait Islander Women during Pregnancy and Beyond: Research Protocol for the Which Way? Project

2021 ◽  
Vol 18 (3) ◽  
pp. 1342
Author(s):  
Michelle Bovill ◽  
Catherine Chamberlain ◽  
Jessica Bennett ◽  
Hayley Longbottom ◽  
Shanell Bacon ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Torres Strait Islander ◽  
Aboriginal Health ◽  
Research Process ◽  
Local Health ◽  
Research Protocol ◽  
Smoking During Pregnancy ◽  
Health And Wellbeing ◽  
Online Social Media ◽  
Torres Strait

Strong and healthy futures for Aboriginal and Torres Strait Islander people requires engagement in meaningful decision making which is supported by evidence-based approaches. While a significant number of research publications state the research is co-designed, few describe the research process in relation to Indigenous ethical values. Improving the health and wellbeing of Aboriginal and Torres Strait Islander mothers and babies is crucial to the continuation of the oldest living culture in the world. Developing meaningful supports to empower Aboriginal and Torres Strait Islander mothers to quit smoking during pregnancy is paramount to addressing a range of health and wellbeing outcomes. Aboriginal and Torres Strait Islander women have called for non-pharmacological approaches to smoking cessation during pregnancy. We describe a culturally responsive research protocol that has been co-designed and is co-owned with urban and regional Aboriginal communities in New South Wales. The project has been developed in line with the AH&MRC’s (Aboriginal Health & Medical Research Council) updated guidelines for ethical research with Aboriginal and Torres Strait Islander communities. Ethics approvals have been granted by AH&MRC #14541662 University of Newcastle HREC H-2020-0092 and the Local Health District ethics committee 2020/ETH02095. Results will be disseminated through peer reviewed articles, community reports, infographics, and online social media content.

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