This World No Tobacco Day is an important reminder that healthcare professionals play an important role in educating and motivating smokers to quit. Primary health practitioners should continuously work to identify smokers, assess their smoking status, and offer them support and cessation treatment options at every opportunity.
In our region, respiratory disease is the third leading cause of death and accounts for 5% of all hospitalisations. The leading cause of respiratory diseases is tobacco smoking. Our region’s smoking in pregnancy rates are consistently higher than the NSW average, with almost 14% of pregnant women smoking during pregnancy.
Tobacco smoking during pregnancy increases the risks of complications, low birthweights and preterm births, and can have serious long-term health risks for both mother's and their babies. After pregnancy, in addition to negatively affecting women's health, smoking exposes babies and young children to environmental tobacco which has been linked to increased risks of sudden infant death syndrome, respiratory illnesses, middle ear infections, and decreased lung function.
Engaging pregnant woman in smoking cessation initiatives is important, as women are more likely to stop smoking during pregnancy, than at any other time of their life. At this time women experience higher levels of social and family support for quitting, and have greater contact with the healthcare system, with 81% of women visiting their GP at least twice during their pregnancy.
This year a Cancer Institute NSW grant funded our Smoking Cessation in Pregnant Women Initiative Smoke Free Mums To Be, which supported general practice to reduce smoking rates amongst pregnant women. This initiative assisted practices with quality improvement activities, provided a workshop for GPs and practice nurses facilitated by an international smoking cessation expert, and provided the carbon monoxide meter Smokerlyser, to participating practices to assist the behavioural intervention.
Participating practices said they had gained additional skills in how to engage pregnant women in smoking cessation interventions, were more confident in prescribing nicotine replacement therapy (NRT) during pregnancy, and had implemented new mechanisms within their practice to monitor patient progress and prevent relapse.
Dr Mark Graydon, from Mt Pleasant Medical Centre said, “Following my participation in the 'Smoke Free Mums To Be workshop' I am able to prescribe and recommend NRT in pregnant women with total confidence. As a result of this initiative I now offer my patients who smoke the use of the Smokerlyser as a visual incentive. Recently, one of my patients who had ceased smoking just a few days prior was pleasantly surprised to see her carbon monoxide levels had already reduced and was further encouraged to maintain her no smoking status, which is a positive outcome for my patient.”
NSW Quitline has recently launched a new secure online Quitline Referral Form to make it easier for all health professionals to refer patients for support. More information about this service is available on the NSW Cancer Institute website.