Screening practices and attitudes of obstetricians-gynecologists toward new and emerging tobacco products

Abstract

OBJECTIVE We examined screening practices and attitudes of obstetricians-gynecologists toward the use of noncombustible tobacco products (chewing tobacco, snuff/snus, electronic cigarettes, and dissolvables) during pregnancy. STUDY DESIGN The authors mailed a survey in 2012 to 1024 members of the American College of Obstetricians and Gynecologists, including Collaborative Ambulatory Research Network (CARN) and non-CARN members. Stratified random selection was used to generate CARN and non-CARN samples. RESULTS Response rates were 52% and 31% for CARN and non-CARN members, respectively. Of 252 total eligible respondents (those currently providing obstetrics care) 53% reported screening pregnant women at intake for noncombustible tobacco product use all or some of the time, and 40% reported none of the time. Respondents who reported that noncombustible products have adverse health effects during pregnancy, but are safer than cigarettes, ranged from 20.2% (dissolvables) to 29% (electronic cigarettes) and that the health effects are the same as those of cigarettes from 13.5% (electronic cigarettes) to 53.6% (chewing tobacco). Approximately 14% reported that electronic cigarettes have no adverse health effects; <1% reported no health effects for the remaining products. Two-thirds of the respondents wanted to know more about the potential health effects of noncombustible tobacco products; only 5% believed themselves to be fully informed. CONCLUSION A large proportion of obstetrician-gynecologists reported never or inconsistently screening their pregnant patients for the use of noncombustible tobacco products. Responses regarding the harms of these products relative to cigarettes were mixed and most respondents wanted more information. Development and dissemination of guidance for providers is needed to improve decision-making regarding noncombustible tobacco products.

Understanding Pregnant Smokers’ Adherence to Nicotine Replacement Therapy During a Quit Attempt: A Qualitative Study

“…We found women were concerned about the health and safety effects of using e-cigarettes during pregnancy. However survey data suggests pregnant women view e-cigarettes as less harmful than smoking 24 , which is similar to the views reported by some young adults 25 and obstetrician-gynaecologists 26 .…”

How do consumers perceive differences in risk across nicotine products? A review of relative risk perceptions across smokeless tobacco, e-cigarettes, nicotine replacement therapy and combustible cigarettes

“…and 23 24A 24B 50 53 56 57–73 In 70% of observational study samples (n=46), a majority of respondents perceived ECs as less harmful than CCs; while in 17% of samples, no clear RRP emerged among a majority of respondents. Among samples recruited using probability-based methods (n=32), this pattern was generally consistent, albeit a majority of respondents perceived ECs as less harmful than CCs in a smaller proportion of samples, while a majority of respondents held this RRP in all non-probability-based samples (n=14).…”

Attitudes and Beliefs Regarding the Utility of Robotically Assisted Gynecologic Surgery Among Practicing Gynecologists

“…Although our survey was associated with a relatively high response rate from a range of general gynecologists and subspecialists, these data may not be representative of all gynecologists in the United States. The College has, however, previously undertaken a number of similar research surveys, and these studies include representative clinicians from across the country (England et al, 2014;Raglan et al, 2014;Wright et al, 2013b). Regardless, this instrument provides a framework for further studies to examine physician attitudes associated with novel technologies and surgical innovation.…”