Lehman College and the Graduate Center, The City University of New York, New York, USA.
Matern Child Health J. 2010 Jul;14(4):600-11. doi: 10.1007/s10995-009-0502-1. Epub 2009 Aug 4.
While prevalence of smoking during pregnancy has declined over the past two decades, maintenance of cessation after pregnancy remains an important public health challenge, particularly for women of color. This article reports on methods for improving detection of women at risk for smoking resumption after pregnancy through the use of an evidence-based smoking assessment instrument. The instrument was adapted for use by lay health workers in a community-based maternal and infant health program. A total of 276 primarily low-income Black and Hispanic pregnant and postnatal women enrolled in the program were screened for tobacco use in an initial assessment. Of these, 190 were reassessed an average of 2.7 months later. Assessments included measures of current and past smoking and risk factors associated with relapse. Bivariate differences by smoking status were analyzed. Seventeen percent of participants who would be classified as non-smokers using less sensitive screening questions were identified as former smokers and at-risk for resuming smoking. Twenty-two percent of former smokers resumed smoking by reassessment. Smoking resumption among former smokers was associated with having a partner and household members who smoked. Identification of former smokers is critical in order to prevent resumption of smoking after pregnancy and promote long-term maternal smoking cessation. Brief assessment instruments administered at multiple points in time during the prenatal and postnatal periods are an effective means of improving detection of women at risk for smoking resumption. Former smokers should be included in prenatal and postnatal tobacco education and counseling services.
尽管过去二十年来孕妇吸烟的比例有所下降，但在怀孕期间戒烟后仍继续保持不吸烟的状态仍是一个重要的公共卫生挑战，尤其是对于有色人种的女性来说。本文介绍了一种通过使用基于证据的吸烟评估工具来提高对孕妇吸烟复发风险的检测方法。该工具适用于社区母婴健康项目中的初级保健工作者。共有 276 名主要来自低收入的黑人和西班牙裔孕妇和产后妇女在该项目的初始评估中接受了烟草使用筛查。其中，190 名妇女在平均 2.7 个月后接受了重新评估。评估包括当前和过去吸烟的测量以及与复发相关的风险因素。对吸烟状况的二元差异进行了分析。使用不太敏感的筛查问题将 17%被归类为非吸烟者的参与者确定为曾经吸烟者，并且有重新开始吸烟的风险。22%的曾经吸烟者在重新评估时重新开始吸烟。曾经吸烟者的吸烟复吸与伴侣和家庭成员吸烟有关。为了防止孕妇吸烟复吸和促进长期的母亲戒烟，识别曾经吸烟者至关重要。在产前和产后期间多次进行简短的评估工具是提高对有吸烟复发风险的女性的检测的有效方法。应该将曾经吸烟者纳入产前和产后的烟草教育和咨询服务中。
