Abstract
Objectives
Our study aims to describe French general practitioners’ (GPs’) practices toward pregnant patients regarding alcohol consumption and smoking and to highlight factors associated with specific practices.
Methods
In 2015, a representative sample of 1414 French GPs completed a telephone survey based on a stratified random sampling.
Results
61% of GPs declared screening for alcohol use and 82% for smoking at least once with each pregnant patient; quitting was not systematically advised either for alcohol or for smoking. GPs’ practices were significantly better among those who had more recent ongoing training. GPs who drank regularly were less likely to screen for alcohol use and GPs’ drinking frequency was inversely related to recommending quitting. Current and former smokers were less likely to recommend quitting to pregnant patients smoking over five cigarettes per day.
Conclusions
Screening and counselling practices for substance use during pregnancy are heterogeneous among French GPs and are notably related to their personal consumption. GP’s role in preventing substance use during pregnancy could be strengthened by actions regarding their own consumption and by modifications in their initial and ongoing training.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ampt AJ, Amoroso C, Harris MF, McKenzie SH, Rose VK, Taggart JR (2009) Attitudes, norms and controls influencing lifestyle risk factor management in general practice. BMC Fam Pract 10:59. https://doi.org/10.1186/1471-2296-10-59
Andler R et al (2016) Tobacco consumption and e-cigarette use in France in 2015: preliminary results from the 2015 cancer barometer. Bull Épidémiol Hebd 30–31:502–507
Barlet M, Coldefy M, Collin C, Lucas-Gabrielli V (2012) L’Accessibilité potentielle localisée (APL): une nouvelle mesure de l’accessibilité aux médecins généralistes libéraux. Questions d’économie de la santé. IRDES, Paris
Beck F, Guignard R, Obradovic I, Gautier A, Karila L (2011) Increasing trends in screening for addictives behaviors among general practitioners in France. Rev D’epidemiol Sante Publique 59:285–294. https://doi.org/10.1016/j.respe.2011.03.059
Bloch J, Cans C, de Vigan C, de Brosses L, Doray B, Larroque B, Perthus I (2008) Feasibility of the foetal alcohol syndrome surveillance. Arch Pediatr 15:507–509. https://doi.org/10.1016/s0929-693x(08)71814-1
Blondel B, Lelong N, Kermarrec M, Goffinet F (2012) Trends in perinatal health in France from 1995 to 2010. Results from the French National Perinatal Surveys. J Gynecol Obstet Biol Reprod 41:e1–e15. https://doi.org/10.1016/j.jgyn.2012.04.014
BMA (2016) Alcohol and pregnancy—preventing and managing fetal alcohol spectrum disorders. British Medical Association, BMA House, Tavistock Square, London
Bohn MJ, Babor TF, Kranzler HR (1995) The alcohol use disorders identification test (AUDIT): validation of a screening instrument for use in medical settings. J Stud Alcohol 56:423–432
Brown J et al (2016) Comparison of brief interventions in primary care on smoking and excessive alcohol consumption: a population survey in England. Br J Gen Pract 66:e1–9. https://doi.org/10.3399/bjgp16x683149
Buyck J-F et al (2016) Attitudes et pratiques des médecins généralistes dans le cadre du suivi de la grossesse. DREES (0977), 8p
Castles A, Adams EK, Melvin CL, Kelsch C, Boulton ML (1999) Effects of smoking during pregnancy five meta-analyses. Am J Prev Med 16:208–215
Chamberlain C, O’Mara-Eves A, Porter J, Coleman T, Perlen SM, Thomas J, McKenzie JE (2017) Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database Syst Rev 2:Cd001055. https://doi.org/10.1002/14651858.cd001055.pub5
Cogordan C, Nguyen-Thanh V, Richard J-B (2016) Alcool et grossesse: connaissances et perception des risques. Alcool Addictol 38:181–190
Collange F, Fressard L, Pulcini C, Sebbah R, Peretti-Watel P, Verger P (2016) General practitioners’ attitudes and behaviors toward HPV vaccination: a French national survey. Vaccine 34:762–768. https://doi.org/10.1016/j.vaccine.2015.12.054
Crawford-Williams F, Steen M, Esterman A, Fielder A, Mikocka-Walus A (2015) “If you can have one glass of wine now and then, why are you denying that to a woman with no evidence”: knowledge and practices of health professionals concerning alcohol consumption during pregnancy Women. Birth 28:329–335. https://doi.org/10.1016/j.wombi.2015.04.003
De Col P, Baron C, Guillaumin C, Bouquet E, Fanello S (2010) Influence of smoking among family physicians on their practice of giving minimal smoking cessation advice in 2008. A survey of 332 general practitioners in Maine-et-Loire. Rev Mal Respir 27:431–440. https://doi.org/10.1016/j.rmr.2010.03.001
Dumas A (2015) Smoking, pregnancy and breastfeeding: exposure, knowledge and risk perceptions. Bull Épidémiol Hebd 17–18:301–307
Engdahl B, Nilsen P (2011) Receiving an alcohol enquiry from a physician in routine health care in Sweden: a population-based study of gender differences and predictors. Int J Environ Res Public Health 8:1296–1307. https://doi.org/10.3390/ijerph8051296
Euro-Peristat (2013) Project with SCPE and EUROCAT. European Perinatal Health Report. The health and care of pregnant women and babies in Europe in 2010. https://www.europeristat.com
Feodor Nilsson S, Andersen PK, Strandberg-Larsen K, Nybo Andersen AM (2014) Risk factors for miscarriage from a prevention perspective: a nationwide follow-up study. BJOG 121:1375–1384. https://doi.org/10.1111/1471-0528.12694
French Reitox National Focal Point (2015) France, new developments, trends. In: Beck F (ed) 2014 national report (2013 data) to the EMCDDA by the Reitox National Focal Point France. New development, trends. OFDT, Saint-Denis
Gautier A (2005) General practitioners/pharmacists health barometer 2003. Health barometers. INPES, Saint-Denis
Gautier A (2011) General practitioners health barometer 2009. Health barometers. INPES, Saint-Denis
Geirsson M, Bendtsen P, Spak F (2005) Attitudes of Swedish general practitioners and nurses to working with lifestyle change, with special reference to alcohol consumption. Alcohol Alcohol 40:388–393. https://doi.org/10.1093/alcalc/agh185
Gelly J et al (2014) Profile of French general practitioners providing opportunistic primary preventive care–an observational cross-sectional multicentre study. Fam Pract 31:445–452. https://doi.org/10.1093/fampra/cmu032
Herrmann M, King K, Weitzman M (2008) Prenatal tobacco smoke and postnatal secondhand smoke exposure and child neuro development. Curr Opin Pediatr 20:184–190. https://doi.org/10.1097/mop.0b013e3282f56165
Hughes JR, Keely J, Naud S (2004) Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction 99:29–38
Ifop, Santé publique France (2013) Counseling for alcohol consumption and smoking among pregnant women (Unpublished study)
Kesmodel US (2016) Risks and guidelines for the consumption of alcohol during pregnancy. World J Obstet Gynecol 5:162–174
Ketterer F et al (2014) What factors determine Belgian general practitioners’ approaches to detecting and managing substance abuse? A qualitative study based on the I-Change Model. BMC Fam Pract 15:119. https://doi.org/10.1186/1471-2296-15-119
Le Maréchal M et al (2015) Design of a national and regional survey among French general practitioners and method of the first wave of survey dedicated to vaccination. Méd Maladies Infectieuses 45:403–410. https://doi.org/10.1016/j.medmal.2015.09.005
Malloy MH, Hoffman HJ, Peterson DR (1992) Sudden infant death syndrome and maternal smoking. Am J Public Health 82:1380–1382
McNeill A, Guignard R, Beck F, Marteau R, Marteau TM (2015) Understanding increases in smoking prevalence: case study from France in comparison with England 2000–10. Addiction 110:392–400. https://doi.org/10.1111/add.12789
Miyake Y, Tanaka K, Okubo H, Sasaki S, Arakawa M (2014) Alcohol consumption during pregnancy and birth outcomes: the Kyushu Okinawa Maternal and Child Health Study. BMC Pregnancy Childbirth 14:79. https://doi.org/10.1186/1471-2393-14-79
Raude J, Fressard L, Gautier A, Pulcini C, Peretti-Watel P, Verger P (2016) Opening the ‘Vaccine Hesitancy’ black box: how trust in institutions affects French GPs’ vaccination practices. Exp Rev Vaccines 15:937–948. https://doi.org/10.1080/14760584.2016.1184092
Richard JB, Beck F (2016) Long-term trends in tobacco and alcohol consumption in France through the lens of gender and social inequalities. Bull Épidémiol Hebd 7–8:126–133
Santé Publique France (2018a) Grossesse Sans Tabac http://www.tabac-info-service.fr/J-arrete-de-fumer/Grossesse-sans-tabac. Accessed 01 Mar 2018
Santé publique France (2018b) L’alcool et la grossesse http://www.alcool-info-service.fr/alcool/consequences-alcool/grossesse-femme-enceinte. Accessed 01 Mar 2018
Saurel-Cubizolles MJ, Prunet C, Blondel B (2013) Alcohol consumption during pregnancy and perinatal health in France in 2010. Bull Épidémiol Hebd 16–18:180–185
Tam CW, Zwar N, Markham R (2013) Australian general practitioner perceptions of the detection and screening of at-risk drinking, and the role of the AUDIT-C: a qualitative study. BMC Fam Pract 14:121. https://doi.org/10.1186/1471-2296-14-121
Underner M, Ingrand P, Allouch A, Laforgue AV, Migeot V, Defossez G, Meurice JC (2006) Influence of smoking among family physicians on their practice of giving minimal smoking cessation advice. Rev Mal Respir 23:426–429
U.S. Department of Health and Human Services (2014) The health consequences of smoking: 50 years of progress. A report of the surgeon general. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health
Valero De Bernabe J, Soriano T, Albaladejo R, Juarranz M, Calle ME, Martinez D, Dominguez-Rojas V (2004) Risk factors for low birth weight: a review. Eur J Obstet Gynecol Reprod Biol 116:3–15. https://doi.org/10.1016/j.ejogrb.2004.03.007
Verger P et al (2015) Vaccine hesitancy among general practitioners and its determinants during controversies: a national cross-sectional survey in France. EBio Med 2:891–897. https://doi.org/10.1016/j.ebiom.2015.06.018
WHO (2013) WHO guidelines approved by the guidelines review committee. In: WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy. World Health Organization, Geneva
WHO (2014) WHO guidelines approved by the guidelines review committee. In: Guidelines for the identification and management of substance use and substance use disorders in pregnancy. World Health Organization, Geneva
Acknowledgements
We thank Romain Guignard, Jean-Baptiste Richard and Arnaud Gautier for their advice during the data analysis and Manon Jeuland for her help with the bibliographic research.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All Authors declares that they have no conflict of interest.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Andler, R., Cogordan, C., Pasquereau, A. et al. The practices of French general practitioners regarding screening and counselling pregnant women for tobacco smoking and alcohol drinking. Int J Public Health 63, 631–640 (2018). https://doi.org/10.1007/s00038-018-1103-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-018-1103-9