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Am J Health Promot. 2013 Jan-Feb;27(3):170-6. doi: 10.4278/ajhp.110624-QUAL-265.

Smoking is bad for babies: obstetric care providers' use of best practice smoking cessation counseling techniques.

Author information

1
Center for Research in Health Care, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, USA. jchang@mail.magee.edu

Abstract

PURPOSE:

To use direct observations of first prenatal visits to describe obstetric providers' adherence to the evidence-based clinical practice guideline for smoking cessation counseling recommended by the American College of Obstetricians and Gynecologists, the 5 A's (Ask, Advice, Assess, Assist, and Arrange).

DESIGN:

Observational study using audio recordings of first obstetric visits.

SETTING:

An urban academic hospital-based clinic.

PARTICIPANTS:

Obstetric care providers and pregnant women attending their first obstetric visit.

METHOD:

First obstetric visits were audio recorded. Visits were identified in which patients reported smoking, and discussions were analyzed for obstetric providers' use of the 5 A's in smoking cessation counseling.

RESULTS:

Obstetric providers asked about smoking in 98% of the 116 visits analyzed, but used 3 or more of the 5 A's in only 21% (24) of visits. In no visits did providers use all 5 A's. In 54% of the visits, providers gave patients information about smoking, most commonly about risks associated with perinatal smoking.

CONCLUSION:

Few obstetric care providers performed the recommended 5 A's smoking cessation counseling with their pregnant smokers. Effective and innovative methods are needed to improve obstetric providers' use of the 5 A's.

PMID:
23286593
PMCID:
PMC3733346
DOI:
10.4278/ajhp.110624-QUAL-265
[Indexed for MEDLINE]
Free PMC Article

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