By Anne Harding
"Because counselling only achieves modest quit rates, we've heard anecdotally that physicians are somewhat unwilling to take the time to counsel pregnant smokers," Van T. Tong of the Centres for Disease Control and Prevention in Atlanta, a researcher on the study, told Reuters Health. "So our results confirmed what we expected."
Smoking during pregnancy can cause a number of problems for mother and child, from preterm delivery to developmental and behavioural problems, Tong and her colleagues note. More than one in 10 women who had babies in the US in 2004 said they smoked while they were pregnant.
To better understand how to help pregnant smokers quit, the researchers analysed 2004 and 2005 data from the New Jersey Pregnancy Risk Assessment Monitoring Program on 4 473 women who had recently given birth.
Among the 16 percent of women in the study who said that they were smokers before they got pregnant, half said they quit before they began receiving prenatal care. Just five percent of smokers quit after starting prenatal care, the investigators report in the American Journal of Preventive Medicine.
Among the women who were still smoking in late pregnancy, only 11 percent reported trying some type of smoking cessation aid, such as counselling or self-help materials.
Almost all of the study participants said that their health care provider had asked them if they smoked, but just 57 percent said that their provider had counselled them on how to quit.
Counselling is the preferred smoking cessation approach for pregnant women, given the potential risks of nicotine gum or patches, or medications like Zyban, Tong commented.
"However, particularly for heavier smokers (more than a pack a day), the potential benefit of quitting smoking may outweigh the risks of the cessation medication," she added. "Women need to talk with their providers to see what would be the best smoking cessation aid for them."
The results can only be generalised to New Jersey, which has one of the lowest rates of smoking during pregnancy in the US, Tong and her colleagues note, possibly thanks to its extensive tobacco-control policies and programs. "However, even in a state with low prenatal smoking, there is a need for improvement to make sure we get women the help they need to quit smoking," Tong said.
"We need to get more providers to offer it despite their fears that it won't achieve success," she added. "Every woman counts, so if they could counsel and refer every pregnant smoker, that's really our goal."