Family Physicians' Perceived Prevalence, Safety, and Screening for Cigarettes, Marijuana, and Electronic-Nicotine Delivery Systems (ENDS) Use during Pregnancy
Family Physicians' Perceived Prevalence, Safety, and Screening for Cigarettes, Marijuana, and Electronic-Nicotine Delivery Systems (ENDS) Use during Pregnancy
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DOI：
10.3122/jabfm.2017.06.170183
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发表时间：
2017-11-01
影响因子：
2.9
通讯作者：
Stotts, Angela L.
中科院分区：
文献类型：
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作者：
Northrup, Thomas F.;Klawans, Michelle R.;Stotts, Angela L.
目的：评估提供产科护理的初级保健医生 (PCP) 对香烟和二手烟暴露 (SHSe)、大麻（和合成大麻）、电子尼古丁输送系统（ENDS；例如电子烟）、尼古丁替代疗法 (NRT) 和怀孕期间戒烟药物的流行率、安全性和筛查实践的看法。方法：基于网络的横断面调查已通过电子邮件发送至3750 名美国医生（属于学术家庭医学教育研究联盟理事会内的组织）。调查中包含了几个研究小组的问题。只有自称提供“待产和分娩”产科护理的医生回答了与研究目标相关的问题。结果：共有 1248 名医生（共 3750 名）做出了回应（33.3%），其中 417 名医生报告提供了待产和分娩产科护理。产科服务提供者 (N = 417) 报告称，“部分（6% 至 25%）”孕妇使用香烟（54%）、大麻（49%）和电子尼古丁传送系统（24%），其中 37% 的受访者表示“极少数（1% 至 5%）”孕妇使用电子尼古丁传送系统。提供者最常选择很少孕妇使用 NRT（45%）、戒烟药物（即安非他酮或伐尼克兰；37%）和合成大麻（23%）。很大一部分人对合成大麻（58%）和 ENDS（27%）选择“不知道”。超过 90% 的样本认为，在怀孕期间使用或接触香烟 (99%)、合成大麻 (99%)、二手烟 (97%)、大麻 (92%) 或 ENDS (91%) 是不安全的，但 NRT (44%) 除外。提供者最一致地筛查香烟（85％）和大麻使用（63％），其次是家庭中的SHSe（48％），ENDS（33％）和合成大麻使用（28％）。不到四分之一 (18%) 对所有物质和 SHSe 进行了一致筛查。三分之一 (32%) 报告了大麻实验室检测，3% 报告了吸烟状况实验室检测。结论：在学术环境中提供产科护理的 PCP 样本认为，在怀孕期间使用香烟、大麻和 ENDS 很普遍且不安全。怀孕期间增加对这些物质的筛查的机会是显而易见的。
Objective: Assess perceptions of prevalence, safety, and screening practices for cigarettes and second-hand smoke exposure (SHSe), marijuana (and synthetic marijuana), electronic nicotine delivery systems (ENDS; eg, e-cigarettes), nicotine-replacement therapy (NRT), and smoking-cessation medications during pregnancy, among primary care physicians (PCPs) providing obstetric care.Methods: A web-based, cross-sectional survey was e-mailed to 3750 US physicians (belonging to organizations within the Council of Academic Family Medicine Educational Research Alliance). Several research groups' questions were included in the survey. Only physicians who reported providing "labor and delivery" obstetric care responded to questions related to the study objectives.Results: A total of 1248 physicians (of 3750) responded (33.3%) and 417 reported providing labor and delivery obstetric care. Obstetric providers (N = 417) reported cigarette (54%), marijuana (49%), and ENDS use (24%) by "Some (6% to 25%)" pregnant women, with 37% endorsing that "Very Few (1% to 5%)" pregnant women used ENDS. Providers most often selected that very few pregnant women used NRT (45%), cessation medications (ie, bupropion or varenicline; 37%), and synthetic marijuana (23%). Significant proportions chose "Do not Know" for synthetic marijuana (58%) and ENDS (27%). Over 90% of the sample perceived that use of or exposure to cigarettes (99%), synthetic marijuana (99%), SHS (97%), marijuana (92%), or ENDS (91%) were unsafe during pregnancy, with the exception of NRT (44%). Providers most consistently screened for cigarette (85%) and marijuana use (63%), followed by SHSe in the home (48%), and ENDS (33%) and synthetic marijuana use (28%). Fewer than a quarter (18%) screened consistently for all substances and SHSe. One third (32%) reported laboratory testing for marijuana and 3% reported laboratory testing for smoking status.Conclusion: This sample of PCPs providing obstetric care within academic settings perceived cigarettes, marijuana, and ENDS use to be prevalent and unsafe during pregnancy. Opportunities for increased screening during pregnancy across these substances were apparent.