Reducing smoking during pregnancy and postpartum: physician's advice supported by individual counseling.
Reducing smoking during pregnancy and postpartum: physician's advice supported by individual counseling.
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怀孕期间和产后减少吸烟：医生的建议得到个人咨询的支持。
DOI：
10.1006/pmed.1998.0287
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Mead,PB
中科院分区：
文献类型：
--
作者：
Secker-Walker,RH;Solomon,LJ;Flynn,BS;Skelly,JM;Mead,PB
背景医生建议帮助孕妇在产前护理期间戒烟，结果喜忧参半。培训和促使医生提供一致的建议和转介到现场的支持可能会提高戒烟率。MethodsPregnancy women who smoked被随机分配到接受结构化的建议，从他们的医生和转介到个人行为改变咨询在产前护理或接受简短的建议，戒烟和戒烟小册子在他们的第一次访问。吸烟状况的自我报告，呼出的一氧化碳，尿可替宁。结果相比，通常的护理，更大比例的干预组妇女报告不吸烟在第36周的访问（14%比10%），并在产后1年（18%比11%），但这些差异并不显着。然而，在第二次访问时，干预组中报告不吸烟或减少吸烟量50%或更多的比例明显更高（43% vs 29%，P = 0.02），在第36周访视时（40%vs25%，P < 0.01），产后1年（26%vs14%，P = 0.02）。结论通过对医生进行培训，使其了解如何获得孕妇吸烟者改变其吸烟行为的承诺，办公室提示系统，个性化的吸烟行为改变咨询在减少怀孕期间和产后吸烟方面显示出希望，但需要开发实用的方法，以帮助怀孕吸烟者在定期产前检查期间尝试戒烟。
BackgroundPhysicians' advice to help pregnant women quit smoking during prenatal care has had mixed results. Training and prompting physicians to provide consistent advice and referral to on-site support might improve cessation rates.MethodsPregnant women who smoked were randomly assigned to receive structured advice from their physician and referral to individual behavior change counseling during prenatal care or to receive brief advice to stop smoking and a quit smoking booklet at their first visit. Smoking status was measured by self-report, exhaled carbon monoxide, and urinary cotinine.ResultsCompared with usual care, greater proportions of intervention group women reported not smoking at the 36th-week visit (14% vs 10%) and at 1 year postpartum (18% vs 11%), but these differences were not significant. However, significantly greater proportions of intervention group women reported either not smoking or reducing their cigarette consumption by 50% or more at their second visit (43% vs 29%,P= 0.02), at their 36th-week visit (40% vs 25%,P< 0.01), and at 1 year postpartum (26% vs 14%,P= 0.02).ConclusionsPhysician training on how to gain a pregnant smoker's commitment to change her smoking behavior, an office prompt system, and individualized smoking behavior change counseling show promise in reducing smoking during pregnancy and postpartum, but practical methods to assist pregnant smokers between regular prenatal visits, as they attempt to quit, need to be developed.