Smoking Cessation in Pregnancy

Question 1

What should be done when a female smoker initially presents as being pregnant?

Answer 1

• Discuss smoking risk (amount, length etc)
• Consider CO testing.
• PILS for smoking cessation
• Advise on health benefits
• Explain to pt: normal to refer all to stop smoking services.
• Ask if partner or significant contacts smoke.

Question 2

Who can you refer pregnant women or their partners to?

Answer 2

• NHS Pregnancy Smoking Helpline number (0800 1699 169)
• Local Smoking cessation services.

Question 3

Which pregnant women should be referred?

Answer 3

• Women who say they smoke
• Women with CO > 7ppm
• Quit in the last 2 weeks.

Question 4

What would a CO level of 3ppm mean?

Answer 4

They are infrequent, light smokers or that their partner smokes.

(Note: may be higher if partner smokes)

Question 5

How should you follow up with women who have been referred?

Answer 5

• Check if they took up the referral
• If they took up the referral - give positive feedback.
• If not and further referral declined then accept non-judgementally.

Question 6

What are the benefits of stopping smoking in pregnancy?

Answer 6

• Fewer pregnancy related complications
• Reduced risk of stillbirth
• Healthier baby
• Increased chance of healthier weight. (Mother’s who smoke have underweight babies)
• Reduced chance of cot death.