Pregnancy and Tobacco: experts recommend to improve the information of women and carers

It is necessary to improve information for pregnant women and caregivers to reduce smoking during pregnancy, said several experts at the Consensus Conference on the theme "pregnancy and tobacco"

Caregivers are the first examples

The jury's findings of this consensus conference held in Lille (North) were conducted under the auspices of the National Agency for Accreditation and Evaluation in Health (Anaes).

In France, nearly 30% of pregnant women smoke. To reduce this percentage, the experts proposed several measures.

First, "caregivers should lead by example, because a study showed that patients stop rate is multiplied by 2 when caregivers do not smoke," insisted Michel Delcroix, organizer of the consensus conference and president of the Association perinatal prevention research information (APPRIs).

This exemplary passes including the signing of the charter of the network "maternity without tobacco".

Then, experts recommend to improve information for patients throughout pregnancy.

Indeed, a small study of the national health insurance fund for self-employed (Canam) showed that 27% of women giving birth say he was not informed of the harmful effects of smoking during pregnancy.

"For fear of guilt pregnant smokers, caregivers sometimes were issuing any information, which is idiocy," fumed Professor Gerard Dubois, the medical evaluation unit at the University Hospital of Amiens (Somme).

Information should be provided in part at the "minimal board", which is currently based on two simple questions: "do you smoke?" and "Do you want to quit?". If the patient answers yes to the second question, the caregiver gives information leaflets and support smoking cessation.

A minimum generalize Board

Several experts expressed concern that the minimum board is often replaced by a message such that "it is better still smoking five cigarettes a day rather than being stressed."

They recommended that the minimum board is provided by all health professionals have to meet pregnant women GPs, dentists, obstetricians, pharmacists, anesthetists, midwives, ...

However, this minimal approach, which reduces by 3% the number of pregnant women who smoke, not really directed to women already motivated to quit.

A member of the public proposed to add a third question to double smoking cessation rates. If the answer to the second question is no, she suggested asking "do you have any fears about quitting?" To better target the type of assistance the patient needs and engage .

In addition, the tester carbon monoxide (CO) expired facilitates awareness of the importance of smoking cessation, agreed to tell the experts who advocated routine use during follow-up visits during pregnancy .

In order to provide effective assistance to pregnant smokers, they recommended to establish on the site of the maternity specialist smoking cessation clinics by a midwife or doctor trained in smoking addiction.

According to Gabrielle Lalande, tobacco specialist physician at the University Hospital of Tours (Indre-et-Loire), the maternity record should include a medical component of alcohol, cannabis, tobacco and other products by the pregnant woman as well as her husband. For her, systematic issues should also be included in the book during each follow-up visit.

This book should provide assessment of anxiety and dependency scales and déculpabilisants advice, she added.