Papadakis Sophia, Vyzikidou Vergina Konstantina, Vivilaki Victoria G, Vardavas Constantine I, Loukopoulou Andriani N, Peleki Theodosia, Evangelopoulou Vaso, Behrakis Panagiotis
George D. Behrakis Research Lab, Hellenic Cancer Society, Athens, Greece.
Institute of Public Health, American College of Greece, Athens, Greece.
Eur J Midwifery. 2018 Nov 28;2:16. doi: 10.18332/ejm/99543. eCollection 2020.
Maternal smoking constitutes a significant risk to the fetus and is associated with multiple adverse pregnancy outcomes. Despite this, an estimated 6-19% of women in Europe smoke during pregnancy. We conducted a pilot study to examine the feasibility and effectiveness of the clinical practice recommendations of the 2017 Tobacco Cessation Guidelines for High-Risk Groups (TOB-G) for pregnant and postpartum women in an outpatient obstetrics setting.
The guideline recommendations were tested on a sample of 67 pregnant women recruited from obstetrics outpatient visits. Pregnant women who smoked received three behavioural counselling sessions through a combination of face-toface and telephone consultations by a midwife trained in the TOBG tobacco treatment recommendations. Smoking status was assessed at 1 month and at 6 months follow-up via self-report.
Seventy-one per cent of pregnant smokers screened agreed to participate in the counselling intervention. Pregnant women participants (mean age, M=31.73 years, SD±6.09) smoked for an average of 12.2 (SD±6.55) years. Women reported smoking an average of 4.82 (SD±4.14) cigarettes per day with 51% reporting smoking within 30 minutes of waking, an indicator of higher levels of nicotine addiction. Rates of smoking abstinence among pregnant women undergoing the counselling intervention were 43.9% and 45.6% at the 1 month and at 6 months follow-up, respectively. Replacing those participants with missing data as smokers, the quit rates were 26.9% and 38.8% at the 1 month and 6 months follow-up, respectively.
The counselling intervention delivered to pregnant women who smoke was feasible to implement in a manner that was consistent with the TOB-G guideline recommendations in an outpatient obstetrics setting. Future work should focus on increasing uptake of evidence-based tobacco treatment recommendations in outpatient obstetrics settings.
孕妇吸烟对胎儿构成重大风险，并与多种不良妊娠结局相关。尽管如此，据估计欧洲有6% - 19%的女性在孕期吸烟。我们开展了一项试点研究，以检验2017年高危人群戒烟指南（TOB - G）中针对门诊产科环境下孕妇及产后女性的临床实践建议的可行性和有效性。
在从产科门诊招募的67名孕妇样本上测试指南建议。吸烟的孕妇通过接受过TOBG烟草治疗建议培训的助产士进行面对面和电话咨询相结合的方式，接受了三次行为咨询。通过自我报告在1个月和6个月随访时评估吸烟状况。
接受筛查的吸烟孕妇中有71%同意参与咨询干预。参与的孕妇（平均年龄，M = 31.73岁，标准差±6.09）平均吸烟12.2（标准差±6.55）年。女性报告平均每天吸烟4.82（标准差±4.14）支，51%的女性报告在醒来后30分钟内吸烟，这是尼古丁成瘾程度较高的一个指标。接受咨询干预的孕妇在1个月和6个月随访时的戒烟率分别为43.9%和45.6%。将缺失数据的参与者视为吸烟者，1个月和6个月随访时的戒烟率分别为26.9%和38.8%。
对吸烟孕妇实施的咨询干预在门诊产科环境中以符合TOB - G指南建议的方式实施是可行的。未来的工作应侧重于提高门诊产科环境中基于证据的烟草治疗建议的采用率。
