Call to Action to Reduce Tobacco Use During Pregnancy

Abstract

Tobacco use is a leading preventable cause of adverse maternal and child health outcomes. However, many women in the United States still report smoking during the third trimester of pregnancy. Smoking rates during pregnancy are particularly high among vulnerable women, such as those who experience mental illness, substance use disorder, homelessness, or interpersonal violence. The Tobacco Control Vaccine is a model based on population-level, evidence-based practices to reduce tobacco use. The four elements of the Tobacco Control Vaccine are access to treatment for tobacco dependence, smoke-free policies, increased tobacco taxes, and media campaigns. The purpose of this commentary is a call to action for health care providers to advocate for increased access to treatment for tobacco dependence; stay up-to-date on innovative, tailored treatment practices; and advocate for comprehensive, smoke-free policies, higher tobacco taxes, and media campaigns to help pregnant women quit smoking and avoid relapse in the postpartum period.

Reducing tobacco use among women of childbearing age: Contributions of tobacco regulatory science and tobacco control.

“…To disseminate new knowledge and novel findings about evidence-based tobacco cessation treatments for women of childbearing age, researchers and clinicians alike should attend national conferences targeting maternal-child health care providers. At present, a recent review of abstracts presented at the Society for Maternal-Fetal Medicine and ACOG annual meetings indicated that just 0.48% and 0.47% were focused on smoking, respectively (Fallin-Bennett, Scott, Fallin-Bennett, & Ashford, 2019). This is clearly a missed opportunity to educate health care providers on innovative and efficacious approaches to treating tobacco use and dependence among women of childbearing age.…”

Active or passive maternal smoking increases the risk of low birth weight or preterm delivery: Benefits of cessation and tobacco control policies

“…Clinicians have a responsibility to facilitate a safe and guilt-free environment for all pregnant women, to provide them with support, information and motivational tools adapted to enable them to stop smoking and avoid exposure to secondhand smoke. To achieve this, the means of effective action are: access to nicotine replacement therapy (NRT), other tobacco addiction treatments as well as cognitive behavioral therapies, application of smoke-free policies, media campaigns, and increased tobacco taxes 68 , 71 , 96 .…”

Cigarette smoking cessation and mental health treatment receipt in a U.S national sample of pregnant women with mental illness

“…In addition, an advocacy for community tobacco control policies is required (e.g., increased tobacco taxes and smoke‐free policies) as they can enhance maternal‐child health outcomes (Faber et al, 2017). Finally, pregnancy is an opportune time; thus, interest groups of health care providers and nurses (i.e., maternal‐child, psychiatric mental health, family and community) should advocate for smoking counselling in all women and offer additional support for those with mental illness to quit smoking (Fallin‐Bennett et al, 2019; Tong et al, 2016).…”

“…Likewise, pregnant women with past‐month and past‐year psychological distress reported a significant increase in cigarette smoking from 2008 to 2014 (Goodwin et al, 2017). It is critical for researchers and clinicians to address smoking among pregnant women with mental illness (Fallin‐Bennett et al, 2019), because pregnancy provides a unique opportunity to intervene to help women quit smoking. A population‐based study revealed that pregnancy has a positive effect on smoking cessation, as pregnant women tended to quit smoking before the end of first trimester of pregnancy, beginning in the second month (Alshaarawy & Anthony, 2015).…”