“My mother smoked [when she was pregnant] with me and I am fine.”
“I’d rather smoke a cigarette than take a drink of alcohol to relieve stress.”
“So you’re bored, what are you going to do? Sit down and smoke a cigarette.”
“It relaxes me.”
Tobacco use during pregnancy has been associated with many adverse effects, including abruptio placentae, fetal malpresentation, low Apgar scores, stillbirth, and birth defects such as gastroschisis and cleft lip or palate. Most nurses probably see these as no-brainer reasons for women to stop smoking once they become pregnant. Yet a new research study illustrates that the reasons pregnant women might continue to smoke are very individual, and that clinicians are not always skillful in supporting smoking cessation.
In this month’s AJN, researcher Geraldine Rose Britton and colleagues share the results of their qualitative study on the experiences of pregnant smokers and their health care providers. The researchers used a focus group methodology to learn about the smokers’ experiences and to better understand what motivated them to quit or prevented them from doing so. There were also separate clinician focus groups to explore the approach of the 45 providers (71% RNs, 11% physicians, plus one NP, one nurse manager, four LPNs, and one PA) to pregnant women who smoke.
Not surprisingly, the researchers discovered that the issue is frustrating to both pregnant women and their maternity care providers. Some physicians and nurses felt unprepared to coach their pregnant patients in smoking cessation. And some patients used terms such as “preachy,” “judgmental,” “lecture,” and “hounding” when describing their discussions about smoking with physicians or nurses. One woman said she was “made to feel like a bad and stupid person” for continuing to smoke.
See “The Experiences of Pregnant Smokers and Their Providers” in the June issue to learn more about barriers to quitting during pregnancy, patients’ suggestions for more effective anti-smoking messaging, and the authors’ recommendations for policy and practice.