Doctors' attitudes and practices regarding smoking cessation during pregnancy
Date
2005-05
Authors
Everett, K.
Odendaal, H. J.
Steyn, K.
Journal Title
Journal ISSN
Volume Title
Publisher
Health and Medical Publishing Group (HMPG)
Abstract
Objective. To investigate the current smoking cessation practices and attitudes of doctors working in the public antenatal services, as well as their perceived barriers to addressing the issue in the context of routine care. Study design. The study was qualitative, consisting of 14 semi-structured, one-to-one interviews with doctors purposefully sampled from 5 public sector hospitals in Cape Town, South Africa. Results. The doctors in this study regarded HIV, poor nutrition, alcohol abuse and psychosocial stress as equal or higher risks to pregnant women than smoking. They tended to underestimate the magnitude of the risk of smoking during pregnancy. Doctors were unaware of the guidelines offering clinicians brief, structured approaches to smoking cessation counselling and were generally pessimistic that they could influence the smoking behaviour of pregnant women, especially poor, disadvantaged women who face multiple barriers to achieving health-enhancing behaviour. However, most doctors were concerned about improving their communication with pregnant women about smoking and open to adopting new approaches or tools that could assist them. Perceived barriers to providing smoking cessation interventions included a lack of counselling skills and educational resources, other pressing priorities, too little time, and the levels of stress currently experienced by doctors and midwives working in public sector hospitals as a result of dramatic staff and budget cuts. Conclusion. The study suggests that doctors working in the public sector antenatal services are not routinely addressing the issue of smoking during pregnancy or using effective methods to assist women to give up smoking. Doctors need convincing that smoking cessation interventions can be effective. The promotion and provision of evidence-based guidelines such as the Clinical Practice Guideline for Treating Tobacco Use and Dependence (Fiore, 2000), with minimal training, is a possible strategy for integrating smoking cessation interventions into routine antenatal care in South Africa.
Description
The original publication is available at http://www.samj.org.za
Keywords
EMTREE medical terms: alcoholism; article; doctor patient relation; evidence based medicine; female; health behavior; human; Human immunodeficiency virus infection; interview; medical education; medical practice; mental stress; midwife; nutrition; patient counseling; physician attitude; practice guideline; pregnancy; prenatal care; qualitative research; risk assessment; risk factor; smoking cessation; South Africa MeSH: Attitude of Health Personnel; Counseling; Female; Humans; Physician's Role; Pregnancy; Pregnancy Complications; Smoking; Smoking Cessation Medline is the source for the MeSH terms of this document., Prenatal care, Smoking cessation, Fetus -- Effect of tobacco on, Pregnant women -- Tobacco use, Smoking -- Pregnancy -- Child health
Citation
Everett, K, Odendaal, HJ & Steyn, K 2005, 'Doctors' attitudes and practices regarding smoking cessation during pregnancy', South African Medical Journal, vol. 95, no. 5, pp. 350-354.