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- Title
Smoking cessation in pregnancy: An update for maternity care practitioners.
- Authors
Diamanti, Athina; Papadakis, Sophia; Schoretsaniti, Sotiria; Rovina, Nikoletta; Vivilaki, Victoria; Gratziou, Christina; Katsaounou, Paraskevi A.
- Abstract
INTRODUCTION This paper provides an up-to-date summary of the effects of smoking in pregnancy as well as challenges and best practices for supporting smoking cessation in maternity care settings. METHODS We conducted a qualitative review of published peer reviewed and grey literature. RESULTS There is strong evidence of the effects of maternal tobacco use and secondhand smoke exposure on adverse pregnancy outcomes. Tobacco use is the leading preventable cause of miscarriage, stillbirth and neonatal deaths, and evidence has shown that health effects extend into childhood. Women who smoke should be supported with quitting as early as possible in pregnancy and there are benefits of quitting before the 15th week of pregnancy. There are a variety of factors that are associated with tobacco use in pregnancy (socioeconomic status, nicotine addiction, unsupportive partner, stress, mental health illness etc.). Clinical-trial evidence has found counseling, when delivered in sufficient intensity, significantly increases cessation rates among pregnant women. There is evidence that the use of nicotine replacement therapy (NRT) may increase cessation rates, and, relative to continued smoking, the use of NRT is considered safer than continued smoking. The majority of women who smoke during pregnancy will require support throughout their pregnancy, delivered either by a trained maternity care provider or via referral to a specialized hospital or community quitsmoking service. The 5As (Ask, Advise, Assess, Assist, Arrange) approach is recommended for organizing screening and treatment in maternity care settings. Additionally, supporting smoking cessation in the postpartum period should also be a priority as relapse rates are high. CONCLUSIONS There have been several recent updates to clinical practice regarding the treatment of tobacco use in pregnancy. It is important for the latest guidance to be put into practice, in all maternity care settings, in order to decrease rates of smoking in pregnancy and improve pregnancy outcomes.
- Subjects
PREGNANCY complication risk factors; PERINATAL death; COUNSELING; INTERPERSONAL relations; MATERNAL health services; EVALUATION of medical care; MENTAL illness; NICOTINE; PASSIVE smoking; PUERPERIUM; SMOKING; SMOKING cessation; SPOUSES; PSYCHOLOGICAL stress; SUBSTANCE abuse; SOCIAL support; SOCIOECONOMIC factors; NICOTINE replacement therapy; MATERNAL exposure; PREGNANCY
- Publication
Tobacco Induced Diseases, 2019, Vol 17, p1
- ISSN
2070-7266
- Publication type
Article
- DOI
10.18332/tid/109906