Project TEAM
Children's exposure to second-hand smoke is associated with recurring ear infections
and colds and more serious ailments, including:
- Sudden infant death syndrome.
- Asthma, either initiation or exacerbation of existing disease.
- Pneumonia, bronchitis, and other respiratory infections.
Interventions for those of child-bearing age or for parents often focus on the
benefits to the unborn or the children. These arguments can prove persuasive and
powerful (Table 2).
| Table 2: U.S. Department of Health and Human Services Clinical Practice Guideline,
Treating Tobacco Use and Dependence |
| Clinical Practice |
Rationale |
|
Assess pregnant women's tobacco use
status using a multiple-choice question
to improve disclosure.
|
Many pregnant women deny smoking, and the
multiple-choice format improves disclosure. For
example:
"Which of the following statements best describes your
cigarette smoking?"
- I smoke regularly now—about the same as before
finding out I was pregnant.
- I smoke regularly now, but I've cut down since I found
out I was pregnant.
- I smoke every once in a while.
- I have quit smoking since finding out I was pregnant.
- I wasn't smoking around the time I found out I was
pregnant, and I don't currently smoke cigarettes.
|
|
Congratulate those smokers who have quit on their own.
|
To encourage continued abstinence.
|
|
Motivate quit attempts by providing
educational messages about the
impact of smoking on both the
woman's and the fetus' health.
|
These are associated with higher quit rates.
|
|
Give clear strong advice to quit as soon as possible.
|
Quitting early in pregnancy provides the greatest benefits to fetus.
|
|
Suggest the use of problem solving
methods and provide social support
and pregnancy-specific self-help
materials.
|
Reinforces pregnancy-specific benefits and ways to
achieve cessation.
|
|
Arrange for follow-up assessments
throughout pregnancy, including further
encouragement of cessation.
|
The woman and her fetus will benefit even when quitting occurs late in pregnancy.
|
|
In the early postpartum period, assess
for relapse and use relapse prevention
strategies recognizing that patients
may minimize or deny.
|
Postpartum relapse rates are high even if a woman
maintains abstinence throughout pregnancy. Relapse
prevention may start during pregnancy.
|
|
Special Populations: Smoking in Adolescents
Imagine the high school in your neighborhood. If you live in a city, it is possible that you
will find 3,000 students in that school. Now imagine that one day, every one of the
students in that school became a smoker. If you can imagine that, then you have an idea
of how many adolescents become regular smokers every day in the United States.
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