Advertisement

Training obstetric and family practice residents to give smoking cessation advice during prenatal care

  • Author Footnotes
    a From the Office of Health Promotion Research
    ,
    Author Footnotes
    c From the Department of Obstetrics, University of Vermont.
    Roger H. Seeker-Walker
    Correspondence
    Reprint requests: R.H. Secker-Walker, MB, BChir, 235 Rowell Building, University of Vermont, Burlington, VT 05405.
    Footnotes
    a From the Office of Health Promotion Research
    c From the Department of Obstetrics, University of Vermont.
    Affiliations
    Burlington, Vermont
    Search for articles by this author
  • Author Footnotes
    b From the Department of Psychology, Family Practice
    ,
    Author Footnotes
    c From the Department of Obstetrics, University of Vermont.
    Laura J. Solomon
    Footnotes
    b From the Department of Psychology, Family Practice
    c From the Department of Obstetrics, University of Vermont.
    Affiliations
    Burlington, Vermont
    Search for articles by this author
  • Author Footnotes
    a From the Office of Health Promotion Research
    ,
    Author Footnotes
    c From the Department of Obstetrics, University of Vermont.
    ,
    Author Footnotes
    e From the Vermont Cancer Center, University of Vermont.
    Brian S. Flynn
    Footnotes
    a From the Office of Health Promotion Research
    c From the Department of Obstetrics, University of Vermont.
    e From the Vermont Cancer Center, University of Vermont.
    Affiliations
    Burlington, Vermont
    Search for articles by this author
  • Author Footnotes
    a From the Office of Health Promotion Research
    Sandy S. LePage
    Footnotes
    a From the Office of Health Promotion Research
    Affiliations
    Burlington, Vermont
    Search for articles by this author
  • Author Footnotes
    a From the Office of Health Promotion Research
    Jane E. Crammond
    Footnotes
    a From the Office of Health Promotion Research
    Affiliations
    Burlington, Vermont
    Search for articles by this author
  • Author Footnotes
    a From the Office of Health Promotion Research
    ,
    Author Footnotes
    c From the Department of Obstetrics, University of Vermont.
    ,
    Author Footnotes
    e From the Vermont Cancer Center, University of Vermont.
    John K. Worden
    Footnotes
    a From the Office of Health Promotion Research
    c From the Department of Obstetrics, University of Vermont.
    e From the Vermont Cancer Center, University of Vermont.
    Affiliations
    Burlington, Vermont
    Search for articles by this author
  • Author Footnotes
    d From the Department of Gynecology, University of Vermont.
    Philip B. Mead
    Footnotes
    d From the Department of Gynecology, University of Vermont.
    Affiliations
    Burlington, Vermont
    Search for articles by this author
  • Author Footnotes
    a From the Office of Health Promotion Research
    b From the Department of Psychology, Family Practice
    c From the Department of Obstetrics, University of Vermont.
    d From the Department of Gynecology, University of Vermont.
    e From the Vermont Cancer Center, University of Vermont.
      This paper is only available as a PDF. To read, Please Download here.
      Objective: Our objective was to determine the effectiveness of training obstetric and family practice residents to provide smoking cessation advice.
      Study Design: The effectiveness of the trained residents' advice was assessed from exit interviews of pregnant smokers taking part in a randomized, controlled trial of smoking cessation advice. Exit interview responses were compared by χ2 analysis.
      Results: Training resulted in significant changes in the advice provided by the residents, with greater emphasis on gaining a commitment to smoking behavior change, but not in the average time providing the advice, approximately 3 minutes. Adherence to the protocol was maintained at 80%. Significantly more women who received the brief structured advice agreed to stop smoking (54%) or cut down their cigarette consumption (28%) compared with women in the control group (14% and 6%, respectively), p = 0.0001.
      Conclusion: The structured advice consistently provided by the trained residents was effective in gaining commitments from pregnant smokers to change their smoking behavior.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • US Department of Health and Human Services
        The health consequences of smoking for women.
        in: A report of the Surgeon General. Department of Health and Human Services, Washington1983 (USGPO no 1983-410 889/1284)
        • Population Information Program
        • Johns Hopkins University
        Tobacco—hazards to health and human reproduction.
        Popu Rep [L]. 1979; 1: 1-37
        • Fergusson DM
        • Horwood LJ
        • Shannon FT
        Smoking during pregnancy.
        Aust N Z J Med. 1979; 89: 41-43
        • Williamson DF
        • Serdula MK
        • Kendrick JS
        • Binkin NJ
        Comparing the prevalence of smoking in pregnant and nonpregnant women, 1985 to 1986.
        JAMA. 1989; 261: 70-74
        • Sexton M
        • Hebel R
        A clinical trial of change in maternal smoking and its effect on birth weight.
        JAMA. 1984; 251: 911-915
        • Windsor RA
        • Cutter C
        • Morris J
        • et al.
        The effectiveness of smoking cessation methods for smokers in public maternity clinics: a randomized trial.
        Am J Public Health. 1985; 76: 1389-1392
        • Ershoff DH
        • Mullen PD
        • Quinn VP
        A randomized trial of a serialized self-help smoking cessation program for pregnant women in an HMO.
        Am J Public Health. 1989; 79: 182-187
        • MacArthur C
        • Newton JR
        • Knox EG
        Effect of anti-smoking health education on infant size at birth: a randomized trial.
        Br J Obstet Gynaecol. 1987; 94: 295-300
        • Olds DL
        • Henderson CR
        • Tatelbaum R
        • Chamberlain R
        Improving the delivery of prenatal care and outcomes of pregnancy: a randomized trial of nurse home visitation.
        Pediatrics. 1986; 77: 16-22
        • Donovan JW
        Randomized controlled trial of anti-smoking advice in pregnancy.
        Br J Prev Soc Med. 1977; 31: 6-12
        • Wilson DM
        • Taylor DW
        • Gilbert JR
        • et al.
        A randomized trial of a family physician intervention for smoking cessation.
        JAMA. 1988; 260: 1570-1574
        • Kottke TE
        • Brekke ML
        • Solberg LI
        • Hughes JR
        A randomized trial to increase smoking intervention by physicians: doctors helping smokers, round 1.
        JAMA. 1989; 261: 2101-2106
        • Cohen SJ
        • Stookey GK
        • Katz BP
        • Drook CA
        • Smith DM
        Encouraging primary care physicians to help smokers quit: a randomized, controlled trial.
        Ann Intern Med. 1989; 110: 648-652
        • Cummings SR
        • Coates TJ
        • Richard RJ
        • et al.
        Training physicians in counseling about smoking cessation: a randomized trial of the “Quit for Life” program.
        Ann Intern Med. 1989; 110: 640-647
        • Ockene JK
        Physician-delivered intervention for smoking cessation: strategies for increasing effectiveness.
        Prev Med. 1987; 16: 723-737
        • Glynn TJ
        • Manley MW
        How to help your patients stop smoking: a National Cancer Institute manual for physicians. National Cancer Institute, Bethesda, Maryland1989 (NIH publication no 89-3064)
        • Louis Harris and associates
        Health maintenance. Pacific Life Insurance, Newport Beach, California1978
        • Ockene JK
        • Quirk ME
        • Goldberg RJ
        • et al.
        A residents' training program for the development of smoking intervention skills.
        Arch Intern Med. 1988; 148: 1039-1045
        • Kottke TE
        • Battista RN
        • DeFreise GH
        • Brekke ML
        Attributes of successful smoking cessation interventions in medical practice: a meta-analysis of 39 controlled trials.
        JAMA. 1988; 259: 2883-2889
        • Orleans CT
        Understanding and promoting smoking cessation: overview and guidelines for physician intervention.
        Annu Rev Med. 1985; 36: 51-61
        • Russell M
        • Wilson C
        • Taylor C
        • Baker C
        Effect of general practitioners' advice against smoking.
        BMJ. 1979; 2: 231-235
        • Solberg LI
        • Maxwell PL
        • Kottke TE
        • Gepner GJ
        • Brekke NL
        A systematic primary care office-based smoking cessation program.
        J Fam Pract. 1990; 30: 647-654
        • Strecher VJ
        • O’Malley MS
        • Villagra VG
        • et al.
        Can residents be trained to counsel patients about quitting smoking?.
        J Gen Intern Med. 1991; 6: 9-17
        • Bronson DL
        • Flynn BS
        • Solomon LJ
        • et al.
        Smoking cessation counseling during periodic health examinations.
        Arch Intern Med. 1989; 149: 1653-1656