A pilot study of the Tobacco Treatment Guidelines for High-Risk Groups (TOB-G) for pregnant and postpartum women

Sophia Papadakis; Vergina Konstantina Vyzikidou; Victoria G Vivilaki; Constantine I Vardavas; Andriani N Loukopoulou; Theodosia Peleki; Vaso Evangelopoulou; Panagiotis Behrakis

doi:10.18332/ejm/99543

A pilot study of the Tobacco Treatment Guidelines for High-Risk Groups (TOB-G) for pregnant and postpartum women

Eur J Midwifery. 2018 Nov 28:2:16. doi: 10.18332/ejm/99543. eCollection 2020.

Authors

Sophia Papadakis^{1

2

3

4}, Vergina Konstantina Vyzikidou¹, Victoria G Vivilaki⁵, Constantine I Vardavas^{1

2

6}, Andriani N Loukopoulou⁷, Theodosia Peleki^{1

2}, Vaso Evangelopoulou^{1

6}, Panagiotis Behrakis^{1

2

6

8

9}

Affiliations

¹ George D. Behrakis Research Lab, Hellenic Cancer Society, Athens, Greece.
² Institute of Public Health, American College of Greece, Athens, Greece.
³ Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.
⁴ Faculty of Medicine, University of Ottawa, Ottawa, Canada.
⁵ Midwifery Department, University of West Attica, Athens, Greece.
⁶ Hellenic Centre for Disease Control and Prevention, Athens, Greece.
⁷ General Oncological Hospital of Kifisia, Athens, Greece.
⁸ Biomedical Research Foundation of the Athens Academy, Athens, Greece.
⁹ Academy of Medicine, University of Athens, Athens, Greece.

Abstract

Introduction: Maternal smoking constitutes a significant risk to the fetus and is associated with multiple adverse pregnancy outcomes. Despite this, an estimated 6-19% of women in Europe smoke during pregnancy. We conducted a pilot study to examine the feasibility and effectiveness of the clinical practice recommendations of the 2017 Tobacco Cessation Guidelines for High-Risk Groups (TOB-G) for pregnant and postpartum women in an outpatient obstetrics setting.

Methods: The guideline recommendations were tested on a sample of 67 pregnant women recruited from obstetrics outpatient visits. Pregnant women who smoked received three behavioural counselling sessions through a combination of face-toface and telephone consultations by a midwife trained in the TOBG tobacco treatment recommendations. Smoking status was assessed at 1 month and at 6 months follow-up via self-report.

Results: Seventy-one per cent of pregnant smokers screened agreed to participate in the counselling intervention. Pregnant women participants (mean age, M=31.73 years, SD±6.09) smoked for an average of 12.2 (SD±6.55) years. Women reported smoking an average of 4.82 (SD±4.14) cigarettes per day with 51% reporting smoking within 30 minutes of waking, an indicator of higher levels of nicotine addiction. Rates of smoking abstinence among pregnant women undergoing the counselling intervention were 43.9% and 45.6% at the 1 month and at 6 months follow-up, respectively. Replacing those participants with missing data as smokers, the quit rates were 26.9% and 38.8% at the 1 month and 6 months follow-up, respectively.

Conclusions: The counselling intervention delivered to pregnant women who smoke was feasible to implement in a manner that was consistent with the TOB-G guideline recommendations in an outpatient obstetrics setting. Future work should focus on increasing uptake of evidence-based tobacco treatment recommendations in outpatient obstetrics settings.

Keywords: TOB-G; guidelines; midwives; pregnancy; smoking cessation; tobacco.