Licata Milly, Doherty Emma, Farragher Eva, Desmet Clare, Lecathelinais Christophe, Tully Belinda, Wiggers John, Kingsland Melanie, Daly Justine
Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia.
Hunter Medical Research Institute, New Lambton, NSW, Australia.
Nicotine Tob Res. 2025 Jan 22;27(2):300-307. doi: 10.1093/ntr/ntae196.
Antenatal clinical guidelines recommend antenatal care providers routinely assess the smoking status of all pregnant women at the first antenatal visit and, for women who are current smokers, provide cessation support at the first and all subsequent visits. This study aimed to assess women's receipt of comprehensive guideline-recommended care for smoking during pregnancy and the maternal and service characteristics associated with such care.
A telephone survey was conducted with women who were recently pregnant and received antenatal care from public maternity services in one Australian local health district.
Of the 514 participants, 9% were smokers when they found out they were pregnant. Of these, 47% continued smoking until giving birth. Almost all participants (96%) were asked about their smoking status at their first antenatal visit. Among pregnant smokers, 76% were asked about their smoking at subsequent visits, 73% were advised to quit, 62% were provided with information or advice to assist in quitting, 24% were offered nicotine replacement therapy, and 38% were offered a referral to Quitline. A third of maternal smokers reported receiving all elements of guideline-recommended care. No associations were found between maternal and service characteristics and receipt of care for smoking.
Guideline recommended routine assessment and care for smoking in pregnancy may be less than optimal, particularly for smoking cessation interventions with strong evidence of effectiveness-NRT and quitlines. Identification of barriers and implementation of strategies to increase the offer and uptake of these services by women is required.
This study is the first to examine pregnant women's reported receipt of comprehensive guideline-recommended care for maternal smoking. The findings indicate that a significant proportion of pregnant women attending public maternity services are not receiving comprehensive care and that many are not being offered evidence-based interventions to assist them to quit. Barriers to comprehensive care delivery need to be identified and addressed if the potential for smoking interventions delivered in this setting to impact smoking rates in pregnancy is to be realized.
产前临床指南建议，产前护理提供者应在首次产前检查时常规评估所有孕妇的吸烟状况，对于目前仍在吸烟的孕妇，在首次及随后的每次检查时都应提供戒烟支持。本研究旨在评估孕妇在孕期是否接受了指南推荐的全面吸烟护理，以及与这种护理相关的孕产妇和服务特征。
对近期怀孕并在澳大利亚一个地方卫生区的公共产科服务机构接受产前护理的女性进行了电话调查。
在514名参与者中，9%在发现自己怀孕时是吸烟者。其中，47%一直吸烟到分娩。几乎所有参与者（96%）在首次产前检查时都被询问了吸烟状况。在怀孕吸烟者中，76%在随后的检查中被询问了吸烟情况，73%被建议戒烟，62%得到了有助于戒烟的信息或建议，24%获得了尼古丁替代疗法，38%被转介到戒烟热线。三分之一的吸烟孕妇报告接受了指南推荐护理的所有内容。未发现孕产妇和服务特征与吸烟护理的接受情况之间存在关联。
指南推荐的孕期吸烟常规评估和护理可能未达到最佳效果，尤其是对于有充分有效证据的戒烟干预措施——尼古丁替代疗法和戒烟热线。需要识别障碍并实施策略，以增加这些服务的提供并提高女性对其的接受度。
本研究首次调查了孕妇报告的接受指南推荐的孕产妇吸烟全面护理的情况。研究结果表明，相当一部分在公共产科服务机构就诊的孕妇没有接受全面护理，而且许多人没有得到基于证据的干预措施来帮助她们戒烟。如果要实现这种环境下的吸烟干预措施对孕期吸烟率产生影响的潜力，就需要识别并解决全面护理提供方面的障碍。
