为英格兰孕妇提供戒烟支持：对国民保健署孕妇戒烟服务的在线调查结果
Provision of smoking cessation support for pregnant women in England: results from an online survey of NHS Stop Smoking Services for Pregnant Women.
作者信息
Fahy Samantha J, Cooper Sue, Coleman Tim, Naughton Felix, Bauld Linda
机构信息
Institute for Social Marketing and U,K, Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, Scotland.
出版信息
BMC Health Serv Res. 2014 Mar 4;14:107. doi: 10.1186/1472-6963-14-107.
BACKGROUND
Smoking during pregnancy is a major public health concern and an NHS priority. In 2010, 26% of UK women smoked immediately before or during their pregnancy and 12% smoked continuously. Smoking cessation support is provided through free at the point of use Stop Smoking Services for Pregnant women (SSSP). However, to date, little is known of how these services provide support across England. The aim of this study was to describe the key elements of support provided through English SSSP.
METHODS
SSSP managers were invited to participate in this survey by email. Data were then collected via an online questionnaire; one survey was completed for each SSSP. Up to four reminder emails were sent over a two month period.
RESULTS
86% (121 of 141) of services completed the survey. Responding services were, on average, larger than non-responding services in terms of the number of pregnant women setting quit dates and successfully quitting (p < 0.01). In line with the 2010 NICE guidelines, Stop Smoking in Pregnancy and following Childbirth, one in five SSSP identified pregnant smokers using carbon monoxide (CO) testing and refer via an opt-out pathway. All services offered nicotine replacement therapy (NRT) to pregnant women and 87% of services also offered dual therapy NRT, i.e. combination of a patch and short acting NRT product.. The 2010 NICE guidelines note that services should be flexible and client-centred. Consistent with this, SSSP offer pregnant women a range of support types (median 4) including couple/family, group (open or closed) or one-to-one. These are available in a number of locations (median 5), including in community venues, clinics and women's homes.
CONCLUSIONS
English Stop Smoking Services offer behavioural support and pharmacotherapy to pregnant women motivated to quit smoking. Interventions provided are generally evidence-based and delivered in a variety of both social and health care settings.
背景
孕期吸烟是一个重大的公共卫生问题，也是英国国民医疗服务体系（NHS）的工作重点。2010年，26%的英国女性在怀孕前或孕期立即吸烟，12%的女性持续吸烟。通过免费的孕期戒烟服务（SSSP）为孕妇提供戒烟支持。然而，迄今为止，对于这些服务在英格兰各地如何提供支持知之甚少。本研究的目的是描述通过英格兰的SSSP提供的支持的关键要素。
方法
通过电子邮件邀请SSSP管理人员参与本次调查。然后通过在线问卷收集数据；每个SSSP完成一份调查问卷。在两个月的时间内发送了多达四封提醒电子邮件。
结果
86%（141个中的121个）的服务机构完成了调查。就设定戒烟日期并成功戒烟的孕妇数量而言，回复调查的服务机构平均比未回复的服务机构规模更大（p < 0.01）。根据2010年英国国家卫生与临床优化研究所（NICE）关于孕期及产后戒烟的指南，五分之一的SSSP通过一氧化碳（CO）检测识别出孕期吸烟的女性，并通过选择退出途径进行转诊。所有服务机构都为孕妇提供尼古丁替代疗法（NRT）, 87%的服务机构还提供双重疗法NRT，即贴片和短效NRT产品的组合。2010年NICE指南指出，服务应该灵活且以客户为中心。与此一致的是，SSSP为孕妇提供一系列支持类型（中位数为4种），包括夫妻/家庭、团体（开放或封闭）或一对一。这些支持在多个地点（中位数为5个）提供，包括社区场所、诊所和女性家中。
结论
英格兰的戒烟服务为有戒烟意愿的孕妇提供行为支持和药物治疗。所提供的干预措施通常基于证据，并在各种社会和医疗环境中实施。
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