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Small SP, Maddigan J, Swab M, Jarvis K. Pregnant and postnatal women's experiences of interacting with health care providers about their tobacco smoking: a qualitative systematic review. JBI Evid Synth 2022:02174543-990000000-00111. [PMID: 36477572 DOI: 10.11124/jbies-22-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this review was twofold: (i) to comprehensively identify the best available evidence about the experiences of women who smoked tobacco during pregnancy or postnatally (or both) concerning health care providers' interactions with them about their smoking, when such interactions occurred during contact for prenatal or postnatal health care in any health care setting; and (ii) to synthesize the research findings for recommendations to strengthen health care providers' interventions regarding smoking during pregnancy and smoking during the postnatal period. INTRODUCTION Maternal tobacco smoking during pregnancy and maternal tobacco smoking postnatally pose serious health risks for the woman, fetus, and offspring, whereas maternal smoking cessation has beneficial health effects. Given the importance of health care providers' interactions with pregnant and postnatal women for smoking cessation care, it is essential to understand women's experiences of such interactions. INCLUSION CRITERIA Studies considered for this review had qualitative research findings about the experiences of women who smoked tobacco during pregnancy or postnatally (or both) in relation to health care providers' interactions with them about their smoking. METHODS The review was conducted using the JBI approach to qualitative systematic reviews. Published studies were sought through 6 academic databases (eg, CINAHL, MEDLINE). Unpublished studies were searched in 6 gray literature sources (eg, ProQuest Dissertations and Theses, Google Scholar). Reference lists of retrieved records were also searched. The searches occurred in October and November 2020; no country, language, or date limits were applied. Study selection involved title and abstract screening, full-text examination, and critical appraisal of all studies that met the inclusion criteria for the review. Study characteristics and research findings were extracted from the included studies. Study selection and extraction of findings were conducted by two reviewers independently; differences between reviewers were resolved through consensus. The research findings were categorized, and the categories were aggregated into a set of synthesized findings. The synthesized finding were assigned confidence scores. The categories and finalized synthesized findings were agreed upon by all reviewers. RESULTS The 57 included studies varied in qualitative research designs and in methodological quality (from mostly low to high). There were approximately 1092 eligible participants, and 250 credible and unequivocal research findings. The research findings yielded 14 categories and 6 synthesized findings with low to very low confidence scores. Some women who smoked tobacco during pregnancy and some women who smoked tobacco postnatally lacked supportive interactions by health care providers regarding their smoking; other women experienced supportive interactions by health care providers. Women were adversely impacted when health care providers' interactions lacked supportiveness, and were beneficially impacted when interactions were supportive. Women varied in openness to health care providers' interactions regarding their smoking, from not being receptive to being accepting, and some women wanted meaningful health care provider interactions. CONCLUSIONS Although confidence in the synthesized findings is low to very low, the evidence indicates that supportive health care provider interactions may facilitate positive smoking behavior change in pregnancy and postnatally. It is recommended that health care providers implement accepted clinical practice guidelines with women who smoke prenatally or postnatally, using an approach that is person-centered, emotionally supportive, engaging (eg, understanding), and non-authoritarian. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020178866.
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Affiliation(s)
- Sandra P Small
- Faculty of Nursing, Memorial University, St. John's, NL, Canada.,Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada
| | - Joy Maddigan
- Faculty of Nursing, Memorial University, St. John's, NL, Canada.,Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada
| | - Michelle Swab
- Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada.,Health Sciences Library, Memorial University, St. John's, NL, Canada
| | - Kimberly Jarvis
- Faculty of Nursing, Memorial University, St. John's, NL, Canada.,Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada
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Small S, Brennan-Hunter A, Yi Y, Porr C. The Understanding of Maternal Smoking among Women who were Smoking or had Quit Smoking during Pregnancy. Can J Nurs Res 2022; 55:250-261. [PMID: 36214102 DOI: 10.1177/08445621221125062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Maternal tobacco smoking during pregnancy is associated with adverse health effects for the woman, fetus, and child, including such serious effects as preterm birth, low birth weight, stillbirth, and neonatal and sudden infant death. Smoking cessation during pregnancy reduces health risks. Purpose In order to support pregnant women to quit smoking, it is essential to know determinants of quitting smoking in pregnancy. The purpose of this research was to examine women's understanding of maternal smoking, in terms of their beliefs, in relation to quitting smoking during pregnancy. Methods The study was a cross-sectional survey with anonymous questionnaires. The sample consisted of 161 pregnant and postnatal women who were continuing or had continued to smoke during pregnancy or had quit smoking during pregnancy. Logistic regression was used to determine the impact of women's understanding of maternal smoking on quitting smoking in pregnancy. Results A large majority of the women had low to moderate understanding of maternal smoking. Those with higher levels of understanding were more likely to quit smoking during pregnancy than were those with a low level of understanding. Not having children prior to the current pregnancy or childbirth also increased the likelihood of quitting smoking during pregnancy while being without a partner combined with having a longer duration of smoking decreased the likelihood of quitting smoking during pregnancy. Conclusion As a modifiable factor, pregnant women's understanding of maternal smoking can be readily targeted with informational interventions in an effort to help them quit smoking.
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Affiliation(s)
- Sandra Small
- Faculty of Nursing, Memorial University, St. John's, NL, Canada
| | | | - Yanqing Yi
- Faculty of Medicine, Memorial University, St. John's, NL, Canada
| | - Caroline Porr
- Faculty of Nursing, Memorial University, St. John's, NL, Canada
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Small SP, Swab M, Maddigan J. Pregnant and postnatal women's experiences of interacting with health care providers about their tobacco smoking: a qualitative systematic review protocol. JBI Evid Synth 2021; 19:652-659. [PMID: 33186296 DOI: 10.11124/jbies-20-00135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to comprehensively identify and synthesize the best available evidence about the experiences of women who smoked tobacco during pregnancy or postnatally (or both) concerning their health care providers' interactions with them about their smoking. INTRODUCTION Smoking tobacco during pregnancy and postnatally continue to be important global public health challenges. Maternal smoking poses risks to the woman's general health and causes pregnancy complications and serious adverse health effects for the fetus and child. Hence, it is essential that health care providers support pregnant and postnatal women to achieve smoking cessation and not relapse. Learning about these women's experiences of health care provider interactions may inform recommendations for health care provider best practice in interpersonal approach. INCLUSION CRITERIA The participants of interest are women who smoked tobacco during pregnancy, the postnatal period, or both, with the phenomenon of interest being their experiences of health care provider interactions with them about their smoking. The context is any setting globally. Studies for consideration will have qualitative data, including any mixed methods studies. METHODS This qualitative systematic review will be conducted according to JBI methodology. Databases to be searched for published studies include CINAHL, PubMed, APA PsycINFO, Embase, Sociological Abstracts, and SocINDEX. Gray literature will be searched for unpublished studies. The authors will conduct an initial screening and then a full-text review of studies for congruence with the inclusion criteria. A critical appraisal will be performed on eligible studies and data will be extracted from included studies. Meta-aggregation will be used to yield synthesized findings, which will be assigned confidence scores. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020178866.
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Affiliation(s)
- Sandra P Small
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, NL, Canada.,Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada
| | - Michelle Swab
- Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada.,Health Sciences Library, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Joy Maddigan
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, NL, Canada
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Small SP, Brennan-Hunter A, Porr C, Yi Y. Challenges Experienced by Women Who Smoke During Pregnancy or Postnatally. INTERNATIONAL JOURNAL OF CHILDBIRTH 2020. [DOI: 10.1891/ijcbirth-d-19-00009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Maternal smoking during pregnancy and maternal smoking postnatally are important public health concerns worldwide. Smoking adversely affects the woman's general health and is causally related to pregnancy complications and serious health outcomes for the child, such as stillbirth, preterm delivery, low birth weight, and sudden infant death. The purpose of this research was to examine maternal smoking through a quantitative descriptive survey of 164 women, 120 who were pregnant and 44 who were postnatal. Women experienced barriers to quitting smoking, including dealing with stress, being exposed to smokers, not being ready to quit, not knowing how to quit, not looking for or not being able to find information about smoking or quitting smoking, and lacking adequate social and healthcare provider support. On the other hand, women revealed characteristics that suggest they might have had improved potential for quitting smoking, including having negative feelings about smoking, having cut down on smoking, smoking at a low level, having made quit attempts, thinking it would not be hard to quit smoking, being in the preparation stage of behavioral change, and thinking their healthcare providers (HCPs) would help them if they decided to quit. Taken together, those findings suggest that HCPs could offer important assistance to help women achieve smoking cessation. However, more research needs to be conducted to clarify the role and effectiveness of various HCPs in smoking cessation interventions and to identify measures to strengthen their provision of such interventions.
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Berlin I, Oncken C. Maternal Smoking During Pregnancy and Negative Health Outcomes in the Offspring. Nicotine Tob Res 2019; 20:663-664. [PMID: 29471548 DOI: 10.1093/ntr/nty035] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Ivan Berlin
- Hôpital Pitié-Salpêtrière-Sorbonne Université, Faculté de médecine-CESP-INSERM, Paris, France
| | - Cheryl Oncken
- University of Connecticut School of Medicineà, Farmington, CT
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Ratsch A, Steadman K, Ryu B, Bogossian F. Tobacco and Pituri Use in Pregnancy: A Protocol for Measuring Maternal and Perinatal Exposure and Outcomes in Central Australian Aboriginal Women. Methods Protoc 2019; 2:E47. [PMID: 31181680 PMCID: PMC6632177 DOI: 10.3390/mps2020047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/04/2019] [Accepted: 06/04/2019] [Indexed: 01/17/2023] Open
Abstract
Maternal tobacco smoking is a recognized risk behavior that has adverse impacts onmaternal and fetal health. However, in some populations, the use of smokeless tobacco exceeds theuse of smoked tobacco. In central Australia, Aboriginal populations utilize wild tobacco plants(Nicotiana spp.) as a smokeless product. These plants are known by a variety of names, one of whichis pituri. The plants are masticated and retained in the oral cavity for extended periods of time andtheir use continues throughout pregnancy, birth, and lactation. In contrast to the evidence related tocombusted tobacco use, there is no evidence as to the effects of pituri use in pregnancy. CentralAustralian Aboriginal women who were at least 28 weeks pregnant were stratified into three tobaccoexposure groups: (a) Pituri chewers, (b) smokers, and (c) non-tobacco users. Routine antenatal andbirth information, pre-existing and pregnancy-related maternal characteristics, fetal characteristics,and biological samples were collected and compared. The biological samples were analysed fortobacco and nicotine metabolite concentrations. Samples from the mother included venous blood,urine, hair and colostrum and/or breast milk. From the neonate, this included Day 1 and Day 3 urineand meconium, and from the placenta, arterial and venous cord blood following delivery. This is thefirst study to correlate the pregnancy outcomes of central Australian Aboriginal women with differenttobacco exposures. The findings will provide the foundation for epidemiological data collection inrelated studies. Note to readers: In this article, the term "Aboriginal" was chosen by central Australianwomen to refer to both themselves and the Aboriginal people in their communities. "Indigenous" waschosen to refer to the wider Australian Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Angela Ratsch
- Research Education, Development and Support, Wide Bay Hospital and Health Service,Hervey Bay 4655, Australia.
| | - Kathryn Steadman
- School of Pharmacy, The University of Queensland, Brisbane 4072, Australia.
| | - BoMi Ryu
- School of Pharmacy, The University of Queensland, Brisbane 4072, Australia.
| | - Fiona Bogossian
- School of Health & Sports Science and School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Maroochydore 4558, Australia.
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane 4072, Australia.
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Patten CA, Lando HA, Desnoyers CA, Barrows Y, Klejka J, Decker PA, Hughes CA, Bock MJ, Boyer R, Resnicow K, Burhansstipanov L. The Healthy Pregnancies Project: Study protocol and baseline characteristics for a cluster-randomized controlled trial of a community intervention to reduce tobacco use among Alaska Native pregnant women. Contemp Clin Trials 2019; 78:116-125. [PMID: 30703523 PMCID: PMC6407629 DOI: 10.1016/j.cct.2019.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/17/2019] [Accepted: 01/25/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Tobacco use prevalence is high among pregnant Alaska Native (AN) women but few interventions have been evaluated for this group. The Healthy Pregnancies Project aims to evaluate a multicomponent intervention for reducing tobacco use during pregnancy and the postpartum period among AN women. This report describes the study protocol and participant baseline characteristics. DESIGN Cluster-randomized controlled trial with village as the unit of assignment. Sixteen villages in rural southwest Alaska were stratified on village size and randomized to a multicomponent intervention (n = 8 villages) or usual care (n = 8 villages). METHODS Pregnant AN women from the study villages were enrolled. All participants receive the usual care provided to pregnant women in this region. Participants from intervention villages additionally receive individual phone counseling on healthy pregnancies plus a social marketing campaign targeting the entire community delivered by local AN "Native Sisters." Baseline measurements for all enrolled pregnant women have been completed. Follow-up assessments are ongoing at delivery, and at 2 and 6 months postpartum. The primary outcome is biochemically verified tobacco use status at 6 months postpartum. RESULTS Recruitment was feasible with 73% of eligible women screened enrolled. The program reached more than half (56%) of AN pregnant women from the study villages during the recruitment period. Participants are N = 352 pregnant AN women, 188 enrolled from intervention villages and 164 from control villages. At baseline, participants' mean (SD) age was 25.8 (5.0) years, they were at 26.8 (9.8) weeks gestation, and 66.5% were current tobacco users. DISCUSSION Processes and products from this project may have relevance to other Native American populations aiming to focus on healthy pregnancies in their communities.
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Affiliation(s)
- Christi A Patten
- Mayo Clinic, Department of Psychiatry and Psychology, BioBusiness Bldg 5-26, 200 First Street SW, Rochester, MN 55905, USA.
| | - Harry A Lando
- University of Minnesota, 1300 2(nd) St, Ste 200, Minneapolis, MN 55454, USA.
| | - Chris A Desnoyers
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA.
| | - Yvette Barrows
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA.
| | - Joseph Klejka
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA.
| | - Paul A Decker
- Mayo Clinic, Department of Health Sciences Research, Harwick 7, 200 First Street SW, Rochester, MN 55905, USA.
| | - Christine A Hughes
- Mayo Clinic, Department of Psychiatry and Psychology, BioBusiness Bldg 5-26, 200 First Street SW, Rochester, MN 55905, USA.
| | - Martha J Bock
- Mayo Clinic, Department of Psychiatry and Psychology, BioBusiness Bldg 5-26, 200 First Street SW, Rochester, MN 55905, USA.
| | - Rahnia Boyer
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA.
| | - Kenneth Resnicow
- University of Michigan, 109 S. Observatory, 3867 SPH1, Ann Arbor, MI 48109, USA.
| | - Linda Burhansstipanov
- Native American Cancer Initiatives, Inc., 3022 South Nova Road, Pine, CO 80470, USA.
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Patten CA, Koller KR, Flanagan CA, Hiratsuka VY, Hughes CA, Wolfe AW, Decker PA, Fruth K, Brockman TA, Korpela M, Gamez D, Bronars C, Murphy NJ, Hatsukami D, Benowitz NL, Thomas TK. Biomarker feedback intervention for smoking cessation among Alaska Native pregnant women: Randomized pilot study. PATIENT EDUCATION AND COUNSELING 2019; 102:528-535. [PMID: 30391300 PMCID: PMC6421103 DOI: 10.1016/j.pec.2018.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 05/16/2023]
Abstract
OBJECTIVE There is some evidence for biomarker feedback when combined with cessation counseling for reducing smoking in pregnancy. This randomized controlled pilot study evaluated feasibility and potential efficacy of a social-cognitive theory (SCT)-based biomarker feedback intervention among pregnant Alaska Native (AN) smokers. METHODS Participants were randomly assigned to receive three study calls (10-20 min each): (1) biomarker feedback intervention (n = 30) including personalized cotinine results and feedback on their baby's likely exposure to carcinogen metabolite NNAL, or (2) contact control usual care condition based on the 5As (n = 30). Assessments were conducted at baseline, post-treatment, and delivery. RESULTS High rates of treatment compliance, study retention, and treatment acceptability were observed in both groups. 7-day point prevalence smoking abstinence rates at delivery verified with urinary cotinine were the same in both study groups (20% intent-to-treat analysis, 26% per-protocol). SCT-based measures did not change differentially from baseline by study group. CONCLUSION This trial supports the feasibility and acceptability of providing biomarker feedback within the clinical care delivery system, but the intervention did not promote increased smoking cessation during pregnancy compared to usual care. PRACTICE IMPLICATIONS Efforts are needed to promote the usual care and to develop alternative biomarker feedback messaging for pregnant AN women.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
| | - Kathryn R Koller
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr., Anchorage, AK, 99508, USA
| | - Christie A Flanagan
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr., Anchorage, AK, 99508, USA
| | - Vanessa Y Hiratsuka
- Southcentral Foundation, Department of Obstetrics and Gynecology, Alaska Native Medical Center, 4320 Diplomacy Dr., Ste. 1800, Anchorage, AK, 99508, USA
| | - Christine A Hughes
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Abbie W Wolfe
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr., Anchorage, AK, 99508, USA
| | - Paul A Decker
- Department of Health Sciences Research, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Kristin Fruth
- Department of Health Sciences Research, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Tabetha A Brockman
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Molly Korpela
- Southcentral Foundation, Department of Obstetrics and Gynecology, Alaska Native Medical Center, 4320 Diplomacy Dr., Ste. 1800, Anchorage, AK, 99508, USA
| | - Diana Gamez
- Southcentral Foundation, Department of Obstetrics and Gynecology, Alaska Native Medical Center, 4320 Diplomacy Dr., Ste. 1800, Anchorage, AK, 99508, USA
| | - Carrie Bronars
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Neil J Murphy
- Southcentral Foundation, Department of Obstetrics and Gynecology, Alaska Native Medical Center, 4320 Diplomacy Dr., Ste. 1800, Anchorage, AK, 99508, USA
| | - Dorothy Hatsukami
- University of Minnesota, 717 Delaware St SE, Minneapolis, MN, 55414, USA
| | - Neal L Benowitz
- Departments of Medicine and Bioengineering and Therapeutic Sciences, University of California, San Francisco, 1001 Potrero Ave, SFGH 30, San Francisco, CA, 94110, USA
| | - Timothy K Thomas
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr., Anchorage, AK, 99508, USA
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Maideen NMP. Tobacco smoking and its drug interactions with comedications involving CYP and UGT enzymes and nicotine. World J Pharmacol 2019; 8:14-25. [DOI: 10.5497/wjp.v8.i2.14] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/20/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023] Open
Abstract
Tobacco smoking is a global public health threat causing several illnesses including cardiovascular disease (Myocardial infarction), cerebrovascular disease (Stroke), peripheral vascular disease (Claudication), chronic obstructive pulmonary disease, asthma, reduced female infertility, sexual dysfunction in men, different types of cancer and many other diseases. It has been estimated in 2015 that approximately 1.3 billion people smoke, around the globe. Use of medications among smokers is more common, nowadays. This review is aimed to identify the medications affected by smoking, involving Cytochrome P450 (CYP) and uridine diphosphate-glucuronosyltransferases (UGTs) enzymes and Nicotine. Polycyclic aromatic hydrocarbons (PAHs) of tobacco smoke have been associated with the induction of CYP enzymes such as CYP1A1, CYP1A2 and possibly CYP2E1 and UGT enzymes. The drugs metabolized by CYP1A1, CYP1A2, CYP2E1 and UGT enzymes might be affected by tobacco smoking and the smokers taking medications metabolized by those enzymes, may need higher doses due to decreased plasma concentrations through enhanced induction by PAHs of tobacco smoke. The prescribers and the pharmacists are required to be aware of medications affected by tobacco smoking to prevent the toxicity-associated complications during smoking cessation.
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Li R, Lodge J, Flatley C, Kumar S. The burden of adverse obstetric and perinatal outcomes from maternal smoking in an Australian cohort. Aust N Z J Obstet Gynaecol 2018; 59:356-361. [PMID: 30014485 DOI: 10.1111/ajo.12849] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/05/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Maternal smoking is associated with a number of adverse outcomes with a dose-dependent increase in risk. The aim of this study was to evaluate the obstetric and perinatal outcomes in women who smoked during pregnancy. METHODS This was a retrospective cohort study of women who smoked during pregnancy and birthed at a major perinatal centre in Australia between January 2000 and April 2017. The study cohort was compared to a cohort of women who did not smoke in pregnancy. Smoking status was ascertained on history and included all types of smoking. Demographic characteristics and obstetric, intrapartum and perinatal outcomes were compared between the two groups. RESULTS The study cohort included 20 477 (14.6%) women who smoked during pregnancy and 119 396 controls. Women who smoked tended to be younger, of higher body mass index (BMI), Caucasian and Indigenous ethnicity. Smokers were less likely to be nulliparous, but more likely to be hypertensive and have a lower socioeconomic status compared to non-smokers. Women who smoked were more likely to have a caesarean section for non-reassuring fetal status (adjusted odds ratio (aOR) 1.16, 95%CI 1.07-1.26, P < 0.001). The infants of women who smoked were more likely to be born preterm, have a lower median birth weight and birth weights <10th (aOR 1.76, 95%CI 1.66-1.86, P < 0.001) and <5th centile (aOR 2.00, 95%CI 1.86-2.16, P < 0.001). Neonatal outcomes in the smoking cohort were worse with an increase in neonatal intensive care unit admission (aOR 1.34, 95%CI 1.27-1.43, P < 0.001), severe acidosis (aOR 1.41, 95%CI 1.27-1.43, P < 0.001) and a composite of severe neonatal outcomes (18.0% vs 12.0%, aOR 1.35, 95%CI 1.28-1.43, P < 0.001). CONCLUSION Women who smoke in pregnancy have worse obstetric and perinatal outcomes compared to controls and should be managed as high risk.
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Affiliation(s)
- Raymond Li
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Jade Lodge
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Christopher Flatley
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Sailesh Kumar
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
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Patten CA, Lando H, Resnicow K, Decker PA, Smith CM, Hanza MM, Burhansstipanov L, Scott M. Developing health communication messaging for a social marketing campaign to reduce tobacco use in pregnancy among Alaska Native women. ACTA ACUST UNITED AC 2018; 11:252-262. [PMID: 31548863 DOI: 10.1080/17538068.2018.1495929] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background Despite the high prevalence of tobacco use during pregnancy among Alaska Native and American Indian (AI/AN) women, few efforts have focused on developing tobacco cessation interventions for this group. This paper describes development of messaging for a social media campaign targeting the entire community to reduce tobacco use in pregnancy (cigarette smoking and smokeless tobacco use including a homemade product known as Iqmik) among AN women, as part of a multi-component intervention. Method The study (clinical trial registration #NCT02083081) used mixed methods with two rounds of assessments to develop and refine culturally relevant message appeals. Round 1 used qualitative focus groups and individual interviews (N=60), and Round 2 used quantitative survey interviews (N=52). Each round purposively sampled adult AN pregnant women, family/friends, and Elders in Western Alaska, and included tobacco users and non-users. Round 1 also assessed reasons for tobacco use in pregnancy. Results Qualitative findings generally converged with quantitative results to indicate that many participants preferred factual, loss-framed, visual concepts on how maternal tobacco use harms the fetus, newborn, and child; in contrast to spiritual or emotional appeals, or gain-framed messaging. Stress was indicated as a major reason for tobacco use in pregnancy and strategies to manage stress along with other health pregnancy targets (e.g., prenatal care) were suggested. Conclusions This preliminary study suggests campaign messages targeting the entire community to reduce tobacco use in pregnancy among rural AN women should include factual messaging for being tobacco-free as well as focus on reducing stress and other healthy pregnancy targets.
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Affiliation(s)
- Christi A Patten
- Mayo Clinic, Department of Psychiatry and Psychology, BioBusiness Bldg 5-26, 200 First Street SW, Rochester, MN 55905, ,
| | - Harry Lando
- University of Minnesota, 1300 2 St, Ste 200, Minneapolis, MN 55454, ,
| | - Kenneth Resnicow
- University of Michigan, 109 S. Observatory, 3867 SPH1, Ann Arbor, MI 48109, ,
| | - Paul A Decker
- Mayo Clinic, Department of Health Sciences Research, Harwick 7, 200 First Street SW, Rochester, MN 55905, ,
| | - Christina M Smith
- Mayo Clinic, Department of Health Sciences Research, Harwick 7, 200 First Street SW, Rochester, MN 55905, ,
| | - Marcelo M Hanza
- Mayo Clinic, Department of Development, Gonda Building, 200 First Street SW, Rochester, MN 55905, ,
| | | | - Matthew Scott
- Yukon Kuskokwim Health Corporation, P.O. Box 528, Bethel, AK 99559-0528, ,
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Massey SH, Decety J, Wisner KL, Wakschlag LS. Specification of Change Mechanisms in Pregnant Smokers for Malleable Target Identification: A Novel Approach to a Tenacious Public Health Problem. Front Public Health 2017; 5:239. [PMID: 28975128 PMCID: PMC5610685 DOI: 10.3389/fpubh.2017.00239] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/23/2017] [Indexed: 12/20/2022] Open
Abstract
Maternal smoking during pregnancy (MSDP) continues to be a leading modifiable risk factor for perinatal complications and a range of neurodevelopmental and cardio-metabolic outcomes across the lifespan. Despite 40 years of intervention research less than one in five pregnant smokers who receive an intervention quit by delivery. Within this context, recognition of pregnancy is commonly associated with abrupt suspension or reduction of smoking in the absence of intervention, yet has not been investigated as a volitional target. The goal of this article is to provide the empirical foundation for a novel direction of research aimed at identifying malleable targets for intervention through the specification of behavior change mechanisms specific to pregnant women. To do so, we: (1) summarize progress on MSDP in the United States generated from conventional empirical approaches to health behavior change; (2) discuss the phenomenon of spontaneous change in the absence of intervention among pregnant smokers to illustrate the need for mechanistic specification of behavior change motivated by concern for fetal well-being; (3) summarize component processes in neurobiological models of parental and non-parental social behaviors as a conceptual framework for understanding change mechanisms during pregnancy; (4) discuss the evidence for the malleability of these processes to support their translational relevance for preventive interventions; and (5) propose a roadmap for validating the proposed change mechanism using an experimental medicine approach. A greater understanding of social and interpersonal processes that facilitate health behavior change among expectant mothers and how these processes differ interindividually could yield novel volitional targets for prenatal interventions. More broadly, explicating other-oriented mechanisms of behavior change during pregnancy could serve as a paradigm for understanding how social and interpersonal processes positively influence health behaviors across the lifespan.
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Affiliation(s)
- Suena H. Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL, United States
| | - Jean Decety
- Department of Psychology, University of Chicago, Chicago, IL, United States
| | - Katherine L. Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lauren S. Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL, United States
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Kleykamp BA. Objectivity and Evidence in the 2016 Surgeon General's Report on E-Cigarettes. Nicotine Tob Res 2017; 20:1031-1032. [PMID: 29065201 PMCID: PMC6037068 DOI: 10.1093/ntr/ntx156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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