Glover Marewa, Paynter Janine, Bullen Chris, Kristensen Kay
Social and Community Health, School of Population Health, University of Auckland, Private Bag 92019, Auckland, New Zealand.
N Z Med J. 2008 Mar 14;121(1270):53-65.
This study examined New Zealand general practitioners' (GPs) and midwives' smoking cessation knowledge and support offered to pregnant women who smoke.
Postal survey of a random sample of 776 New Zealand GPs and midwives, undertaken between September and October 2006.
Responses were received from 39% (147/376) GPs and 57% (203/355) midwives. Almost all GPs indicated that they were involved in confirming pregnancy during the first trimester, compared with only 55% of midwives. There was high reported routine recording of smoking status (84.5% for GPs and 98.5% for midwives) and almost all participants thought it was consistent with their role to ask about smoking in pregnancy, discuss the effects of smoking, and ask if women who smoke wanted to stop smoking. Whilst 71% of GPs reported usually advising pregnant women who smoke to abstain completely only 11% of midwives said they do this. Midwives were much more likely to advise cutting down. Over 60% of participants said they usually provide cessation counselling to pregnant women. Reported recommendation of nicotine replacement therapy (NRT) was low. Only 34% of GPs and 31% of midwives were likely to recommend nicotine gum.
GPs are in a pivotal position to offer stop smoking advice at the time of confirmation of pregnancy, when the motivation to quit is highest. Insufficient emphasis on the importance of early and complete smoking abstinence is being given by most midwives. Intermittent nicotine delivery mechanisms (such as the nicotine gum, inhaler, lozenge, or microtab) are not well known and need to be promoted more to pregnant women who smoke.
本研究调查了新西兰全科医生（GPs）和助产士对吸烟孕妇的戒烟知识及所提供的支持。
2006年9月至10月间，对776名新西兰全科医生和助产士进行随机抽样的邮政调查。
39%（147/376）的全科医生和57%（203/355）的助产士回复了问卷。几乎所有全科医生表示他们参与孕早期的妊娠确认，相比之下，只有55%的助产士参与。据报告，吸烟状况的常规记录率很高（全科医生为84.5%，助产士为98.5%），几乎所有参与者都认为询问孕妇吸烟情况、讨论吸烟的影响以及询问吸烟女性是否想戒烟符合他们的职责。虽然71%的全科医生报告通常建议吸烟孕妇完全戒烟，但只有11%的助产士表示他们会这样做。助产士更倾向于建议减少吸烟量。超过60%的参与者表示他们通常会为孕妇提供戒烟咨询。据报告，尼古丁替代疗法（NRT）的推荐率较低。只有34%的全科医生和31%的助产士可能会推荐尼古丁口香糖。
全科医生在确认妊娠时处于提供戒烟建议的关键位置，此时戒烟动机最高。大多数助产士对早期和完全戒烟的重要性强调不足。间歇性尼古丁递送机制（如尼古丁口香糖、吸入器、含片或微片）并不广为人知，需要更多地向吸烟孕妇推广。
