Obstet Gynecol. 2017 Oct;130(4):1. doi: 10.1097/AOG.0000000000002353.
Smoking is the one of the most important modifiable causes of poor pregnancy outcomes in the United States, and is associated with maternal, fetal, and infant morbidity and mortality. The physical and psychologic addiction to cigarettes is powerful; however, the compassionate intervention of the obstetrician-gynecologist can be the critical element in prenatal smoking cessation. An office-based protocol that systematically identifies pregnant women who smoke and offers treatment or referral has been proved to increase quit rates. A short counseling session with pregnancy-specific educational materials and a referral to the smokers' quit line is an effective smoking cessation strategy. The 5A's is an office-based intervention developed to be used under the guidance of trained practitioners to help pregnant women quit smoking. Knowledge of the use of the 5A's, health care support systems, and pharmacotherapy add to the techniques providers can use to support perinatal smoking cessation. The use of alternative forms of nicotine, such as e-cigarettes and vaping, have increased substantially in recent years, but there are little data regarding the health effects of these agents, either in the general population or in pregnant women specifically.
吸烟是美国导致不良妊娠结局的最重要的可改变因素之一，与母婴发病率和死亡率有关。对香烟的身体和心理成瘾是强大的；然而，妇产科医生富有同情心的干预可能是产前戒烟的关键因素。一种基于办公室的方案已被证明可以提高戒烟率，该方案系统地识别吸烟的孕妇，并提供治疗或转介。一次简短的咨询，提供针对怀孕的教育材料，并转介到戒烟热线，是一种有效的戒烟策略。5A 方案是一种基于办公室的干预措施，旨在在经过培训的从业者的指导下使用，以帮助孕妇戒烟。了解 5A 方案的使用、医疗保健支持系统和药物治疗，增加了提供者可以用来支持围产期戒烟的技术。近年来，尼古丁的替代形式，如电子烟和蒸气烟，的使用大幅增加，但关于这些物质的健康影响的数据很少，无论是在普通人群中还是在孕妇中。
