Health care providers' engagement in smoking cessation with pregnant smokers

J Obstet Gynecol Neonatal Nurs. Jan-Feb 2010;39(1):64-77. doi: 10.1111/j.1552-6909.2009.01084.x.


Objective: To review how health care providers' (HCPs) engage in smoking cessation (SC) with pregnant smokers, and to examine the effect of system-level approaches and training initiatives to promote SC provision by HCPs.

Data sources: A comprehensive search of the CINAHL, COCHRANE Library, EMBASE, ERIC, MEDLINE, PsycINFO, and SIGLE databases was conducted.

Study selection: Selected studies assessed the behaviors of HCPs working among pregnant/postpartum girls and women, employed a quantitative approach, and had clearly defined behavioral outcomes of HCPs' delivery of SC to pregnant smokers.

Data extraction: A total of 988 studies were obtained from the literature search, of which 28 publications met the inclusion criteria. The data extracted from the articles are presented under the following areas: how HCPs are engaging pregnant smokers and approaches to enhancing SC by HCP with pregnant smokers.

Data synthesis: Although more than 50% of HCPs are likely to ask women about their smoking status and advise pregnant smokers to quit, fewer than 50% either assess readiness to change, assist in smoking cessation, or arrange for follow-up appointments/referrals. Important provider-specific, patient-specific, and system/organizational barriers were found to hinder the provision of SC by HCP. Several system-level and training approaches to enhancing HCP's engagement in SC with pregnant smokers show merit.

Conclusions: Few HCPs working with pregnant women use all the components of the Agency for Healthcare Research and Quality clinical guidelines. However, system-level and training approaches are effective ways to enhance HCP's engagement in SC; although, the effects of such initiatives may not be sustained. Factors such as the gender of the provider, geographical location, and the use of women-centered treatment approaches could be further examined in relation to provision of SC by HCPs among pregnant smokers.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aftercare
  • Attitude of Health Personnel
  • Female
  • Guideline Adherence
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Patient Education as Topic
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / organization & administration*
  • Pregnancy
  • Pregnancy Complications / prevention & control*
  • Professional Role
  • Referral and Consultation
  • Research Design
  • Smoking Cessation* / methods
  • Smoking Cessation* / statistics & numerical data
  • Smoking Prevention*
  • United States
  • United States Agency for Healthcare Research and Quality