Smoking and Pregnancy: Status Profile 2007

Annie Berthiaume Roberta HealeIrene KorenRachelle Arbour-Gagnon

Funded by the Louise Picard Research Grant

Background

Smoking during pregnancy has many known harmful effects

Women who smoke during pregnancy are faced with many complex issues relating to quitting.

Background

Goals of a snapshot of smoking behaviours in pregnancy in the Sudbury Ontario area:

data about quit attempts,

barriers and supports to cutting down or quitting

role of the health care providers

This will help in planning programming to provide support to pregnant women who smoke.

Design and Sample

Data was collected through a telephone survey.

Sampling frame: 1820 live births in the Sudbury area in 2005target was 317Total consenting is 270 with 9 refusalsSurvey completion March to September

2007

Objectives

To describe smoking and cessation patterns among women prior, during, and after pregnancy.

To Explore access to cessation services and perception of readiness to quit smoking or to remain smoke-free.

To collect Socio-demographic information

To assess potential risk factors for smoking during pregnancy

Eligibility and Recruitment

Inclusion criteria:Mothers who consented to 48 hour

postpartum telephone assessment from Sudbury & District Health Unit RN.

Resident in the City of Greater Sudbury. The sample included both smoking and

non-smoking mothers

Questionnaire

A skip pattern questionnaire to

identify those with smoking behaviour

reviewed smoking patterns, quit attempts, health care provider assistance and family support

Demographic data was collected on both smokers and non-smokers

Outcomes

Tobacco use over study period (n=193)

Smokers* (%)

Before knowing about pregnancy 55 28.5

During first three months of pregnancy 50 25.9

During last six months of pregnancy 46 23.8

1-2 months postpartum 50 25.9

Age of Mothers

Range 17- 41 years Mode = 28 years

Sample Smokers

Level of education

# Number (%)

High school or less

49 32 57.1

Post secondary *

144 24 42.9

Total 193 56 100

Reported household income

Total Sample

# of Smokers

(%)

< $60,000 66 27 60

$60,000 + 98 18 40

Total 164 45 100

Participant view on quitting smoking (n=56)

Min. Max. Mode Median

Importance of quitting

1 10 10 8.0

Confidence to quit

1 10 2 5.5

Commitment to quit

1 10 8 5.0

Health Care Providers

Health Care Provider Sample Asked about smoking

%

Obstetrician 146 128 87.6

Midwife 33 28 84.8

HBHC 60 41 68.3

Family Physician 137 93 67.9

Nurse Practitioner 17 9 52.9

Health Care Provider

Sample Advised to quit smoking

% Assist with pamphlets

% Arrange community referral

%

ObstetricianMidwife*

53 35 66.0 18 34.0 6 11.3

Other** 57 28 49.1 11 19.3 4 7.0

Health Care Provider *

Smokers (n=55)

Non-smokers (n=137)

Number (%) Number (%)

Obstetrician 40 73.2 107 76.6

Midwife 13 23.2 20 14.6

HBHC Nurse 18 33.9 43 29.9

Family Physician 32 58.9 106 75.9

Nurse Practitioner 7 12.5 11 7.3

Discussion

Of the women who reported smoking, 82.1% were under the age of 30. In this sample, more smokers reported a lower household income than non-smokers

Discussion

Most women (54%) made at least one quit attempt during their pregnancy with “cold turkey” identified as the most common strategy.

Discussion

Of the total number of women who smoked before they found out they were pregnant, 17.9 % quit smoking during their pregnancy which is lower than anticipated.

Discussion

The number of women who quit smoking during pregnancy increased over the course of the pregnancy period with rates rising in the post partum period.

Discussion

Women in this sample were more likely to smoke throughout their pregnancy if they reported being daily smokers.

Discussion

Of the Five “A” Strategy of Ask, Advise, Assess, Assist, Arrange the most common intervention by the health care providers of this sample was Ask followed by a sharp drop for the remaining interventions.

Next Steps