News Release

Doctors miss chances to help pregnant women quit smoking

Peer-Reviewed Publication

Center for Advancing Health

Doctors are missing opportunities to help pregnant women quit smoking, a national survey of physicians reveals.

"Although physicians frequently identified the smoking status of pregnant women, they did not often counsel smokers about quitting," says study author Susan Moran, M.D., M.C.S.E., of Harvard Medical School and the Tobacco Research and Treatment Center at Massachusetts General Hospital in Boston.

Smoking while pregnant is harmful because it can lead to low birth weight, complications of pregnancy, and higher rates of birth defects.

The survey of 793 physicians covered 5,622 office visits by pregnant patients. It found that doctors identified smoking status at 81 percent of the visits but provided counseling to quit only 23 percent of the time. The survey analyzed data from 1991 to 1996 from the National Ambulatory Medical Care Survey, an ongoing poll of office-based U.S. physicians.

The study appears in the May-June issue of the journal Nicotine & Tobacco Research.

Moran and her colleagues also found that physicians identified the smoking status of white women more often than other women. However, once pregnant smokers were identified, they received the same rate of counseling regardless of race.

Geography mattered too. Southern and rural physicians were less likely to counsel pregnant smokers than physicians elsewhere in the country or in metropolitan areas.

The study found that doctors were more likely to determine a pregnant woman's smoking status on a return visit than on the first consultation. Moran and colleagues suggest that this may be due to a desire to avoid confrontation with the patient during initial attempts at establishing rapport.

Knowing smoking status early on is important for prompt smoking-cessation counseling, the authors say. This is especially important since cigarette smoking in pregnancy often indicates drug and alcohol use as well.

The survey may underestimate the extent of the problem, the researchers say, since women who are younger, unmarried, less educated and on Medicaid are more likely to smoke. However, the study did not cover hospitals or federally operated medical facilities, where women of lower socioeconomic status might be more likely to seek prenatal care.

In any case, Moran says, smoking status should always be identified for pregnant women so that interventions to stop smoking can be started as soon as possible.

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The study was funded by the U.S. Public Health Service and the National Heart Lung and Blood Institute.

FOR MORE INFORMATION:
Health Behavior News Service: 202-387-2829 or www.hbns.org.
Interviews: Contact Sue McGreevey at 617-724-2764 or smcgreevey@partners.org.
Nicotine & Tobacco Research: Contact Gary E. Swan, Ph.D., at 650-859-5322.

BY AARON LEVIN, CONTRIBUTING WRITER
HEALTH BEHAVIOR NEWS SERVICE


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