Smoking prevalence and smoking cessation services for pregnant women in Scotland
Smoking prevalence and smoking cessation services for pregnant women in Scotland
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DOI：
10.1186/1747-597x-5-1
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发表时间：
2010-01-21
影响因子：
3.3
通讯作者：
Galbraith, Linsey
中科院分区：
文献类型：
--
作者：
Tappin, David M.;MacAskill, Susan;Galbraith, Linsey
背景：超过20%的妇女在整个怀孕期间吸烟，尽管已知对母亲和孩子的风险。参与面对面的支持是衡量服务范围的一个很好的标准。苏格兰政府设定了一个目标，到2010年，8%的吸烟者将通过NHS戒烟服务戒烟。目前，不到4%的人在怀孕期间停止。我们的目的是建立一个分母的怀孕吸烟者在苏格兰和描述比例谁是转介到专家服务，从事一对一的咨询，设定戒烟日期和戒烟4 weeks later.Methods：这是一个描述性的流行病学研究，使用常规收集的数据，补充问卷调查信息，从专业的妊娠停止服务。2005/2006年，52 370名孕妇中有13 266名（25%）在预约分娩时报告目前吸烟，13 266名孕妇中有3 133名（24%）被转介到专家戒烟服务机构。苏格兰为孕妇提供了两种主要类型的专家戒烟支持。第一个涉及使用自我报告和一氧化碳呼气测试对所有孕妇进行识别，常规转诊（1936/3352，58%转诊）到诊所支持（386，11.5%参与）。370名（11%）女性设定了戒烟日期，116名（3.5%）在4周后戒烟。第二项是通过自我报告和转介确定需要帮助的妇女（1 195/2 776，43%转介），以获得家庭支助（377/1 954，19%参与）。409人（15%）设定了戒烟日期，119人（4.3%）在4周后戒烟。家庭支助的费用更高。在苏格兰，只有265/8062（3.2%）的孕妇吸烟者在产妇预约，生活在公认的专家或良好的通用服务的地区，戒烟在2006年。结论：在苏格兰，一小部分孕妇吸烟者支持停止。结果不佳是目前提供服务的每一步-识别、转诊、参与和治疗-都受到限制的结果。许多吸烟者在怀孕预约时没有被询问吸烟情况或提供虚假信息。一氧化碳呼吸测试可以绕过这个困难。已识别的吸烟者可能不会被转介，但选择退出转介政策可以消除这一障碍。在家里订婚可以让更大比例的人设定戒烟日期并戒烟，但成本更高。
Background: Over 20% of women smoke throughout pregnancy despite the known risks to mother and child. Engagement in face-to-face support is a good measure of service reach. The Scottish Government has set a target that by 2010 8% of smokers will have quit via NHS cessation services. At present less than 4% stop during pregnancy. We aimed to establish a denominator for pregnant smokers in Scotland and describe the proportion who are referred to specialist services, engage in one-to-one counselling, set a quit date and quit 4 weeks later.Methods: This was a descriptive epidemiological study using routinely collected data supplemented by questionnaire information from specialist pregnancy cessation services.Results: 13266 of 52370 (25%) pregnant women reported being current smokers at maternity booking and 3133/13266 (24%) were referred to specialist cessation services in 2005/6. Two main types of specialist smoking cessation support for pregnant women were in place in Scotland. The first involved identification using self-report and carbon monoxide breath test for all pregnant women with routine referral (1936/3352, 58% referred) to clinic based support (386, 11.5% engaged). 370 (11%) women set a quit date and 116 (3.5%) had quit 4 weeks later. The second involved identification by self report and referral of women who wanted help (1195/2776, 43% referred) for home based support (377/1954, 19% engaged). 409(15%) smokers set a quit date and 119 (4.3%) had quit 4 weeks later. Cost of home-based support was greater. In Scotland only 265/8062 (3.2%) pregnant smokers identified at maternity booking, living in areas with recognised specialist or good generic services, quit smoking during 2006.Conclusions: In Scotland, a small proportion of pregnant smokers are supported to stop. Poor outcomes are a product of current limitations to each step of service provision-identification, referral, engagement and treatment. Many smokers are not asked about smoking at maternity booking or provide false information. Carbon monoxide breath testing can bypass this difficulty. Identified smokers may not be referred but an opt-out referral policy can remove this barrier. Engagement at home allowed a greater proportion to set a quit date and quit, but costs were higher.