Smoking and Smoking Cessation During Pregnancy and Postpartum
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Smoking and Smoking Cessation During Pregnancy and Postpartum Anne Gadomski
Published online: 10 August 2010 # Springer Science+Business Media, LLC 2010
Abstract Smoking cessation during and after pregnancy can confer many health benefits to women and their children. Smoking behavior can fluctuate from quitting or reducing during the first trimester to relapses later in pregnancy and postpartum. Abstinence during pregnancy is associated with level of addiction, socioeconomic status, level of education, maternal age, age to start smoking, partner's smoking habit, and secondhand smoke exposure. Low-barrier interventions that reach impoverished and disadvantaged women who are most at risk for smoking and also have the hardest time quitting are needed. At a minimum, pregnant smokers should be offered self-help materials and a 10-minute face-to-face psychosocial intervention. Offering incentives to pregnant women to quit smoking is the most effective intervention. Data are inconclusive regarding the efficacy of smoking cessation pharmacotherapy during pregnancy and postpartum. Because there are also safety concerns about fetal exposure, the use of pharmacotherapy for pregnant women remains controversial. Keywords Smoking cessation . Prenatal counseling . Postpartum relapse prevention . Pharmacotherapy . Financial incentives
A. Gadomski (*) Bassett Healthcare, Research Institute, One Atwell Road, Cooperstown, NY 13326, USA e-mail: [email protected]
Introduction Smoking during and after pregnancy poses serious health risks to the child and the mother. These risks include poor pregnancy outcomes, maternal morbidity and mortality (cancer, heart disease, and lung disease) and fetal, infant, and child morbidity (abnormal fetal development, low birth weight, prematurity, sudden infant death syndrome, asthma, and neurocognitive and behavioral problems) [1]. In addition, children born to women who smoke have increased risk of smoking themselves [2], which, in turn, perpetuates the harm caused by smoking during pregnancy. Smoking cessation during and after pregnancy can confer many health benefits to women and their children. Maintaining abstinence through the postpartum period confers benefit to the next pregnancy as well as increasing the woman’s likelihood of abstinence. Pregnancy is an optimal time for smoking cessation interventions because women who are pregnant have a higher success rate in attempts to quit smoking than non-pregnant women [3, 4, 5••]. Women are almost twice as likely to be abstinent when pregnant as when not [6]; thus, pregnancy can be viewed as a window of opportunity for promoting and sustaining smoking cessation. Smoking cessation is increasingly more of a problem in low socioeconomic populations [7]. Although smoking prevalence is decreasing in high-income countries, it is increasing in low- and middle-income countries [5••]. These trends underscore the need for low-cost, low-barrier interventions that reach impoverished and disadvantaged women who are most at risk for smoking and also have t
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