Advertisement

Obstetricians and gynecologists’ perceptions and use of nicotine replacement therapy

  • James H. PriceEmail author
  • Timothy R. Jordan
  • Joseph A. Dake
Article

Abstract

The objective of this study was to assess Ohio obstetricians/gynecologists’ perceptions and use of nicotine replacement therapy (NRT) with pregnant smokers. A three-wave mailing procedure was used and 154 responded (44%) to a valid and reliable 36-item questionnaire regarding: Stage of Change in using NRT, perceptions of prescribing NRT, confidence in using NRT, barriers to prescribing NRT, and use of 5 A’s counseling steps. One-fourth (26%) prescribed NRT to pregnant smokers. One-third (32%) perceived NRT as safe, yet few (14%) perceived it as effective. Respondents were most likely to prescribe NRT if the patient requested it (44%). Those most likely to prescribe NRT were more likely to: perceive use of NRT in pregnancy as safe (OR = 20.0); perceive NRT as effective in pregnancy (OR = 4.3); have high confidence in their ability to effectively prescribe NRT (OR = 3.86); and believed most or some of their colleagues prescribed NRT to pregnant smokers (OR = 6.7). The majority did not prescribe NRT possibly because few respondents received cigarette smoking cessation training in medical school or their residencies. Significant revisions in professional training and more continuing medical education are needed regarding smoking cessation and use of NRT.

Keywords

smoking cessation nicotine pregnant women tobacco use disorder 

Notes

Acknowledgments

Britney Ward, MPH, Northwest Ohio Hospital Council, Toledo, OH for assistance in data collection. This study was funded by the Ohio Tobacco Use Prevention and Control Foundation.

References

  1. 1.
    Ershoff DH, Ashford TH, Goldenberg RL. (2004) Helping pregnant women quit smoking: an overview. Nicotine Tob Res 6:S101–S105CrossRefPubMedGoogle Scholar
  2. 2.
    Chan BC, Koren G. (2003) Pharmacological treatment for pregnant women who smoke cigarettes. Tobacco Induced Diseases 1:165–174CrossRefGoogle Scholar
  3. 3.
    Buka SL, Shenassa ED, Niaura R. (2003) Elevated risk of tobacco dependence among offspring of mothers who smoked during pregnancy: a 30-year prospective study. Am J Psychiatry 160:1978–1984CrossRefPubMedGoogle Scholar
  4. 4.
    Slotkin TA. (1998) Fetal nicotine or cocaine exposure: which one is worse?. J Pharmacol Exp Ther 285:931–945PubMedGoogle Scholar
  5. 5.
    Centers for Disease Control and Prevention. (2004) Smoking during pregnancy – United States, 1990–2002. MMWR 53:911–915Google Scholar
  6. 6.
    Owen L, McNeill A. (2001) Saliva cotinine as indicator of cigarette smoking in pregnant women. Addiction 96:1101–1106CrossRefPubMedGoogle Scholar
  7. 7.
    Klebanoff MA, Levine RJ, Clemens JD, DerSimonian R, Wilkins DG. (1998) Serum cotinine concentration and self-reported smoking during pregnancy. Am J Epidemiol 148:259–262PubMedGoogle Scholar
  8. 8.
    U.S. Department of Health and Human Services. Healthy People 2010. Available from http://www.healthypeople.gov. Accessed February 2, 2005
  9. 9.
    American College of Obstetriciansand Gynecologists. Smoking cessation during pregnancy. (2000) ACOG Education Bulletin, v260. American College of Obstetricians and Gynecologists, Washington, DCGoogle Scholar
  10. 10.
    Fiore MC, Bailey WC, Cohen SJ, Dorfman SF, Fox BJ, Goldstein MG. et al. (2000) A clinical practice guideline for treating tobacco use and dependence. JAMA 283:3244–3254CrossRefPubMedGoogle Scholar
  11. 11.
    Kottke TE, Battista RN, DeFriese GH, Brekke ML. (1988) Attributes of successful smoking cessation interventions in medical practice: a meta-analysis of 39 controlled trials. JAMA 259:2882–2889CrossRefGoogle Scholar
  12. 12.
    Melvin CL, Dolan-Mullen P, Windsor RA, Whiteside HP, Goldenberg RL. (2000) Recommended cessation counseling for pregnant women who smoke: a review of the evidence. Tobacco Control 9(Suppl.3):iii80–iii84PubMedGoogle Scholar
  13. 13.
    U.S. Department of Health and Human Services. (2001) Women and Smoking: A Report of the Surgeon General – 2001. Public Health Service, Centers for Disease Control and Prevention, Office on Smoking and Health, Washington, DCGoogle Scholar
  14. 14.
    Silagy C, Lancaster T, Stead L, Mant D, Fowler G. (2004) Nicotine replacement therapy for smoking cessation (Cochrane Review). Cochrane Library, Issue 4. John Wiley & Sons Ltd., Chichester, UKGoogle Scholar
  15. 15.
    Benowitz NL, Dempsey DA. (2004). Pharmacotherapy for smoking cessation during pregnancy. Nicotine Tob Res 6(Suppl 2):S189–S202CrossRefPubMedGoogle Scholar
  16. 16.
    Schroeder DR, Ogburn PL, Hurt RD, Croghan IT, Ramin KD, Offord KP, Moyer TP. (2002). Nicotine patch use in pregnancy smokers: smoking abstinence and delivery outcomes. J Matern-Fetal Neonatal Med 11:100–107PubMedCrossRefGoogle Scholar
  17. 17.
    Li CQ, Windsor RA, Perkins L, Goldenberg RL, Lowe JB. (1993) The impact on infant birth weight and gestational age on cotinine-validated smoking reduction during pregnancy. JAMA 269:1519–1524CrossRefPubMedGoogle Scholar
  18. 18.
    Mullen PD, Pollak KJ, Titus JP, Sockrider MM, Moy JG. (1998) Prenatal smoking cessation counseling by Texas obstetricians. Birth 25:25–31CrossRefPubMedGoogle Scholar
  19. 19.
    Grimley DM, Bellis JM, Raczynski JM, Henning K. (2001) Smoking cessation counseling practices: a survey of Alabama obstetrician-gynecologists. South Med J 94:297–303PubMedGoogle Scholar
  20. 20.
    Helwig AL, Swain GR, Gottlieb M. (1998) Smoking cessation intervention: the practices of maternity care providers. J Am Board Fam Pract 11:336–340PubMedGoogle Scholar
  21. 21.
    Moran S, Thorndike AN, Armstrong K, Rigotti NA. (2003) Physicians’ missed opportunities to address tobacco use during prenatal care. Nicotine Tob Res 5:363–368PubMedCrossRefGoogle Scholar
  22. 22.
    Chapin J, Root W. (2004) Improving obstetrician-gynecologist implementation of smoking cessation guidelines for pregnant women: an interim report of the American College of Obstetricians and Gynecologists. Nicotine Tob Res 6(Suppl 2):S253-S257CrossRefPubMedGoogle Scholar
  23. 23.
    Prochaska JO, DiClemente CC, Norcross J. (1992) In search of how people change: applications to addictive behaviors. Am Psychol 47:1102–1114CrossRefPubMedGoogle Scholar
  24. 24.
    Edwards P, Roberts I, Clarke M, DiGuiseppi C, Pratap S, Wentz R, Kwan I. (2002) Increasing response rates to postal questionnaires: systematic review. BMJ 324:1183–1187CrossRefPubMedGoogle Scholar
  25. 25.
    King KA, Pealer LN, Bernard AL. (2001) Increasing response rates to mail questionnaires: A review of inducement strategies. American Journal of Health Education 32:4–15Google Scholar
  26. 26.
    Floyd RL, Belodoff B, Sidhu J, Schulkin J, Ebrakim SH, Sokol RJ. (2001) A survey of obstetrician-gynecologists on their patients’ use of tobacco and other drugs during pregnancy. Prenat Neonatal Med 6:201–207Google Scholar
  27. 27.
    Mullen PD. (1999) Maternal smoking during pregnancy and evidence-based intervention to promote cessation. Prim Care 26:577–589PubMedGoogle Scholar
  28. 28.
    McMenamin SB, Schauffer HH, Shortell SM, Reindall TG, Gillies RR. (2003) Support for smoking cessation interventions in physician organizations. Med Care 41:1396–1406CrossRefPubMedGoogle Scholar
  29. 29.
    Biener L, Garrett CA, Gilpin EA, Roman AM, Currivan DB. (2004) Consequences of declining survey response rates for smoking prevalence estimates. Am J Prev Med 27:254–257CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • James H. Price
    • 1
    Email author
  • Timothy R. Jordan
    • 1
  • Joseph A. Dake
    • 2
  1. 1.Department of Public HealthUniversity of ToledoToledoUSA
  2. 2.Division of HealthWayne State UniversityDetroitUSA

Personalised recommendations