Maternal and Child Health Journal

, Volume 14, Issue 6, pp 901–909

Racial/Ethnic Disparities in the Receipt of Smoking Cessation Interventions During Prenatal Care

  • Sarah-Truclinh T. Tran
  • Kenneth D. Rosenberg
  • Nichole E. Carlson
Article

DOI: 10.1007/s10995-009-0522-x

Cite this article as:
Tran, S.T., Rosenberg, K.D. & Carlson, N.E. Matern Child Health J (2010) 14: 901. doi:10.1007/s10995-009-0522-x

Abstract

To explore racial/ethnic disparities in the receipt of optimal smoking cessation counseling during prenatal care. We used data from Oregon’s perinatal surveillance system, the Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) from 2000 to 2001. A stratified random sample of postpartum women were asked questions about events before, during and after pregnancy, including smoking and provision of smoking cessation counseling. The weighted response rate was 78.8% (n = 3,895). Receipt of a clinician protocol for smoking cessation intervention, called the Five A’s (Ask, Advise, Assess, Assist, Arrange), was the outcome of interest. In the Oregon PRAMS survey, we asked women about three of the Five A’s (Ask, Advise, Assist). Of 594 first trimester pregnant smokers, the majority were asked and advised about smoking by a prenatal care provider. However, a substantial proportion of women did not receive assistance to quit and only 42.2% received all three steps. Significant racial/ethnic variations were found only in the Assist step. Compared to non-Hispanic (NH) White women, NH American Indian women had lower odds (adjusted odds ratio [ORa]: 0.45; 95% confidence interval [95% CI] 0.24, 0.85) of receiving all three steps. In contrast, NH Black women had increased odds of receiving all three steps (ORa: 2.43; 95% CI 1.16, 5.10). We conclude that there is a need for prenatal care providers to address tobacco use, especially to Assist quitting, with all pregnant smokers. Healthcare systems should implement system prompts and supports for providers to remind them to address tobacco use with pregnant smokers.

Keywords

RaceDisparitiesSmokingSmoking cessationPRAMSOregon

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Sarah-Truclinh T. Tran
    • 1
  • Kenneth D. Rosenberg
    • 2
  • Nichole E. Carlson
    • 3
  1. 1.Department of Public Health and Preventive MedicineOregon Health & Sciences UniversityPortlandUSA
  2. 2.Office of Family HealthOregon Public Health DivisionPortlandUSA
  3. 3.Department of Biostatistics and InformaticsColorado School of Public Health, University of Colorado DenverDenverUSA