57% of pregnant patients in New Jersey report that their doctors didn't tell them to quit smoking

Reuters reported on October 2, 2008 on a study published in the October, 2008 issue of the American Journal of Preventive Medicine which found tht many doctors don't tell their pregnant smoking patients to quit. 57% of patients in New Jersey said that their doctors did not tell them to quit. Here is a snippet from the Reuters article:

Pregnant women who smoke share this information with their health care providers, but as often as not their provider doesn't counsel them on how to quit, new research shows.

"Because counseling only achieves modest quit rates, we've heard anecdotally that physicians are somewhat unwilling to take the time to counsel pregnant smokers," Van T. Tong of the Centers for Disease Control and Prevention in Atlanta, a researcher on the study, told Reuters Health. "So our results confirmed what we expected."

Smoking during pregnancy can cause a number of problems for mother and child, from preterm delivery to developmental and behavioral problems, Tong and her colleagues note. More than 1 in 10 women who had babies in the US in 2004 said they smoked while they were pregnant.

To better understand how to help pregnant smokers quit, the researchers analyzed 2004 and 2005 data from the New Jersey Pregnancy Risk Assessment Monitoring Program on 4,473 women who had recently given birth.

Among the 16 percent of women in the study who said that they were smokers before they got pregnant, half said they quit before they began receiving prenatal care. Just 5 percent of smokers quit after starting prenatal care, the investigators report in the American Journal of Preventive Medicine.

Among the women who were still smoking in late pregnancy, only 11 percent reported trying some type of smoking cessation aid, such as counseling or self-help materials.

Almost all of the study participants said that their health care provider had asked them if they smoked, but just 57 percent said that their provider had counseled them on how to quit.

Counseling is the preferred smoking cessation approach for pregnant women, given the potential risks of nicotine gum or patches, or medications like Zyban, Tong commented.

"However, particularly for heavier smokers (more than a pack a day), the potential benefit of quitting smoking may outweigh the risks of the cessation medication," she added. "Women need to talk with their providers to see what would be the best smoking cessation aid for them."

The results can only be generalized to New Jersey, which has one of the lowest rates of smoking during pregnancy in the US, Tong and her colleagues note, possibly thanks to its extensive tobacco-control policies and programs. "However, even in a state with low prenatal smoking, there is a need for improvement to make sure we get women the help they need to quit smoking," Tong said.

"We need to get more providers to offer it despite their fears that it won't achieve success," she added. "Every woman counts, so if they could counsel and refer every pregnant smoker, that's really our goal."

This article makes me wonder how many substance abuse counselors encourage their clients to quit?