246399 “Smoking is bad for babies”: Obstetric Care Providers' Smoking Cessation Counseling

Tuesday, November 1, 2011: 4:30 PM

Judy C. Chang, MD, MPH , Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA
Stewart Alexander, PhD , Center for Palliative Care, Duke University School of Medicine, Durham, NC
Cynthia Holland, MPH , Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA
Robert Arnold, MD , University of Pittsburgh School of Medicine, Pittsburgh, PA
Douglas Landsittel, PhD , Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, PA
James Tulsky, MD , Department of Medicine and Center for Palliative Care, Duke University School of Medicine, Durham, NC
Kathryn Pollak, PhD , Community and Family Medicine, Duke University Medical Center, Durham, NC
Objective: To describe obstetric providers' adherence to best practice smoking cessation guidelines. Methods: We audio recorded first obstetric visits, identified visits in which patients reported smoking, and analyzed discussions for obstetric providers' use of the 5 A's (Ask, Advice, Assess, Assist and Arrange) in smoking cessation counseling. Results: Although obstetric providers asked about smoking in 98% of the 116 visits analyzed, in only 24 (21%) of the visits did providers use 3 or more of the 5 A's. No visits had all 5 A's. In 54% of the visits, the provider gave the patient some type of information about smoking; most commonly, this was information about the risks associated with perinatal smoking. Conclusion: When directly observed, few obstetric care providers performed the recommended 5 A's smoking cessation counseling with their pregnant smokers. Effective and innovative methods are needed to improve obstetric providers' use of the 5 A's.

Learning Areas:
Public health or related research

Learning Objectives:
Describe obstetric providers’ use of the 5 A’s during the first obstetric visit. Identify areas for improvement in smoking cessation counseling during the first obstetric visit. Demonstrate the effectiveness and importance of using the 5 A’s as a smoking cessation method in pregnant women.

Keywords: Smoking, Prenatal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the prinicipal investigator of the project from which the data presented was collected. The project researched patient-provider communication about substances. I am also a practicing obstetric care provider who is committed to providing the best possible prenatal care to women.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.